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Carpal Tunnel Syndrome

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Carpal tunnel syndrome

Carpal tunnel syndrome is a compression of the median nerve, which occurs while this nerve passes into the hand. The nerve is located on the palm side of the hand and allows sensation in the thumb, index finger, long finger, and one portion of the ring finger. It can supply the impulse to the muscle going to the thumb. Carpal tunnel syndrome can affect either one or both hands. Swelling inside the wrist leads to carpal tunnel syndrome. It can lead to tingling, weakness, or numbness on the side of the hand and near the thumb.

What is the cause of carpal tunnel syndrome?

The pain in the carpal tunnel is caused by excess pressure that is put on the median nerve and the wrist. If this nerve becomes inflamed, it can lead to swelling. One of the most causes of this inflammation is a medical condition that leads to swelling in the wrist and can sometimes obstruct blood flow. Some of the most frequent conditions that have been associated with carpal tunnel syndrome include thyroid dysfunction, diabetes, high blood pressure, fluid retention due to menopause and pregnancy, or various autoimmune disorders like rheumatoid arthritis, as well as fractures or trauma to the wrist.

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Carpal tunnel syndrome can worsen in cases where the wrist is overextended repeatedly. In cases of repeated motion to the wrist, swelling and compression of the median nerve can occur. This can be caused by any type of repeated movement which overextends the wrist, such as typing or playing the piano, prolonged exposure to vibrations, such as after using power tools or hand tools, and positioning of the wrist while you use a mouse or a keyboard.

Are there risk factors for carpal tunnel syndrome?

Women are at a higher chance of suffering from carpal tunnel syndrome than men. It most frequently affects those between 30 and 60 years old. Certain conditions can increase the risk of suffering from carpal tunnel syndromes, such as arthritis, high blood pressure, and diabetes. Some lifestyle factors might increase the risk for carpal syndromes, such as a sedentary lifestyle, a high body mass index, high salt intake, and smoking. Certain jobs, which include a lot of repetitive movements, also increase the possibility of suffering from carpal tunnel syndromes, such as keyboarding jobs, manufacturing, construction work, or manufacturing.

What symptoms does carpal tunnel syndrome lead to?

Symptoms, which are usually found along the nerve path due to compression of the median nerve, include the hand „falling asleep“ often and dropping objects. Other symptoms include weakness in the muscles of the hand, wrist pain at night which might interfere with sleep, pain, and burning which might travel up the arm, numbness, pain in the thumb, tingling, and pain in the first three fingers of the hand.

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What does diagnosing carpal tunnel syndrome look like?

A doctor can diagnose carpal tunnel syndrome with the use of a combination of your medical history, a physical exam, and tests referred to as nerve conduction studies. During a physical exam, your doctor will evaluate your hand, wrist, shoulder, and neck to make sure that there aren’t any other causes of nerve pressure. Your doctor will also check for swelling, tenderness, or any deformities. The sensation on your fingers will be looked at, as well as the strength of the muscles in your hand.

A nerve conduction study is a diagnostic test that can measure the conduction speed of nerve impulses. Should this test show that the nerve impulses are slower than normal, you might suffer from carpal tunnel syndrome.

How is carpal tunnel syndrome pain managed?

Treating carpal tunnel syndrome will depend on the severity of the symptoms and pain and whether or not it is accompanied by weakness. Your treatment plan will focus on managing the condition without surgery. Some non-invasive treatment options include resting and avoids positions, which might overextend the wrist, mild pain medication, as well as medications that reduce inflammation, wrist splints, which can keep your hand in a neutral position, especially while you’re sleeping, treating any underlying conditions that you might suffer from, such as diabetes or arthritis and steroid injections into the carpal tunnel area, which can reduce inflammation.

In cases where non-conservative treatments don’t work and there is severe damage to the median nerve, surgery might be necessary. During surgery for carpal tunnel syndrome, the band of tissue that crosses the median nerve will be cut, so that pressure is put on the nerve is decreased. There are some factors, which can determine whether the surgery will be successful or not, such as how old the patient is, how long they have been suffering from the symptoms, whether they experience any weakness and whether they suffer from underlying conditions, such as diabetes mellitus. In most cases, the outcome of the surgery is good.

Can carpal tunnel syndrome be prevented?

There are some chances of preventing carpal tunnel syndrome, such as by taking the necessary measurements and making certain lifestyle changes, which reduce the risk factor of developing it. Treating underlying conditions, such as high blood pressure, arthritis and diabetes can also help to reduce the risk for carpal tunnel syndrome. It is also very important to pay attention to hand posture and to avoid any types of activities that might overextend the wrist. Physical therapy sessions can also be of help.

What does the long-term outlook look like for carpal tunnel syndrome patients?

The outlook for carpal syndrome patients depends from individual to individual. Various factors come into play, such as how long the patient has been suffering from carpal tunnel syndrome, what caused the condition, what symptoms have occurred, and what treatment options the patient undergoes. It is also important to follow the instructions of the doctor strictly and to make the necessary lifestyle changes, that can prevent the condition from worsening. It is important that you seek treatment for carpal tunnel syndrome, as leaving it untreated can cause permanent nerve damage, disability, and even entire loss of hand function.

References:
https://www.ncbi.nlm.nih.gov/books/NBK448179/
https://pubmed.ncbi.nlm.nih.gov/28846321/
https://pubmed.ncbi.nlm.nih.gov/28075090/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759938/
DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general information. In no way does any of the information provided reflect definitive treatment advice. It is essential to consult a best-in-class pain management specialist in New York regarding ANY questions or issues. A thorough evaluation should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call your pain doctor to schedule a consultation.

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  • Dr. Raj Raval, M.D.

    1. Board Certified
    2. Interventional Pain & Musculoskeletal Medicine Specialist
  • Education & training

    1. SUNY Downstate PMR Residency
    2. Rutgers University Fellowship
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