Carpal tunnel syndrome is a debilitating condition that occurs when the median nerve becomes compressed or squeezed as it passes through the carpal tunnel in your wrist.
Symptoms of Carpal Tunnel Syndrome
The median nerve is a major nerve that conveys feeling from your hand to your brain and transmits signal from your brain to control muscles that are used to move the thumb and fingers. Carpal tunnel syndrome often tends to develop gradually over several weeks or months. It can cause pins and needles, numbness, tingling and often pain or aching in the hand and wrist. Symptoms may extend into the forearm or further up the arm as far as the shoulder or neck. Normally the thumb, index and middle fingers are worst affected. In the most severe cases the muscles at the base of the thumb become very weak and shrink in size.
Most people find the symptoms are worst at night, causing them to ‘wake and shake’ the hand to gain relief. However, certain daytime activities can often trigger symptoms, such as typing, holding a phone or gripping a steering wheel. One or both hands can be affected by carpal tunnel syndrome and it can be hard to make fine finger movements, such as fastening buttons or holding a pen. You may find your hands becoming weaker causing you to drop things.
Causes of Carpal Tunnel Syndrome
The carpal tunnel is a narrow passageway inside the wrist which is surrounded by bones and ligaments. A number of tendons pass through this space, along with the median nerve, which may become irritated or compressed.
Repetitive hand motions can contribute to carpal tunnel syndrome and women tend to be more at risk, possibly because their anatomy means the carpal tunnel tends to be smaller.
Anything that causes the median nerve to become irritated or squeezed can trigger carpal tunnel syndrome, including inflammation and swelling linked to conditions like rheumatoid arthritis or a wrist fracture that narrows the carpal tunnel.
However, most cases are due to a progressive thickening of a ligament that forms the roof of the tunnel over many years. The following are all risk factors that may increase the risk of irritation to the median nerve:
- Injury to, or osteoarthritis of, the wrist which deforms the small bones and restricts the space within the carpal tunnel.
- People who are born with smaller carpal tunnel (genetic factors).
- A job that involves working with vibrating tools or making repetitive hand or wrist movements
- Being obese.
- Certain types of inflammatory conditions such as rheumatoid arthritis which can cause inflammation in the carpal tunnel.
- Hormonal changes, for example pregnancy or menopause.
Diagnosis of Carpal Tunnel Syndrome
If you suspect you may have carpal tunnel syndrome, it’s important to get a proper diagnosis. Your doctor will talk to you about your symptoms and may ask you to make certain movements to test the strength of your hand muscles. An X-ray may be used to rule out other causes of pain, such as a fracture or arthritis. You may also be given a nerve conduction test to assess how bad the compression of the nerve is. This involves putting electrodes on your fingers and wrist to measure how quickly your nerves respond to the current. Sometimes an ultrasound scan may be used to identify swellings in the tendons or joint.
Does carpal tunnel syndrome require treatment?
Carpal tunnel syndrome sometimes improves without any medical treatment. However, if you are experiencing persistent symptoms, or your finger and thumb have become permanently numb or weak, it is important to get prompt treatment. We offer a highly effective treatment called Carpal tunnel decompression which we will discuss in detail in our next blog.
If you would like information or advice about the symptoms of carpal tunnel syndrome or possible treatment options contact us.
Orthopaedic Consultant & Surgeon | London
Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist). We can also offer consultations either online or face-to-face.
Telephone: 020 376 15987