Carpal Tunnel Syndrome

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By Dr. Stefanie Yao
Published on October 30, 2013

What is carpal tunnel syndrome?

What is Carpal Tunnel Syndrome?

In today’s age of technology and in an era where the use of personal electronics, computers, and keyboards are rampant, Carpal Tunnel Syndrome has become a well-known cause of pain and discomfort in the arms and hands. Typically considered a repetitive stress injury, key features of carpal tunnel syndrome include numbness and tingling in the fingers, decreased grip strength, and possible sensation changes up the arms and into the hands.

Carpal Tunnel Syndrome Causes

There are many things that can contribute to the development of carpal tunnel syndrome and no person or hand is immune. Carpal tunnel can develop in one’s dominant or non-dominant hand. Typically, carpal tunnel syndrome results from repetitive motions over time, such as typing on a keyboard, playing an instrument, or the repeated use of vibrating hand tools. Hormonal changes related to pregnancy as well as certain medical conditions such as diabetes, rheumatoid arthritis, and hypothyroidism can also increase a person’s risk of developing carpal tunnel syndrome.

Other risks may be due to congenital predispositions where the space in which the median nerve travels is narrowed. The American Society for Surgery of the Hand defines carpal tunnel syndrome as median nerve compression neuropathy of the palmar side of the wrist where the nerve passes beneath the transverse carpal ligament.

Median Nerve Compression

Physiologically, carpal tunnel syndrome occurs when the tissues surrounding the flexor tendons in the wrist swell and place pressure on the median nerve. Over time, the swelling begins to compress the median nerve and restrict median nerve conduction, which supplies sensation and motor muscle control to the thumb and index finger.

Carpal Tunnel Syndrome Symptoms

Those affected by carpal tunnel tend to notice pain upon awakening as well as while performing certain daily activities, such as driving, holding a book, or repetitive hand motions which require prolonged grasping or flexing of the wrist. Certain activities such as buttoning a shirt and grasping small objects may be difficult as well.

Individuals with carpal tunnel syndrome can often be found shaking their hands out trying to find relief. Most people with carpal tunnel also notice sensation changes such as tingling into the hands and arms, as well as hand and wrist swelling. Over time, symptoms of carpal tunnel can worsen, leading to persistent sensation changes such as numbness and in some severe cases loss of grip strength. Muscle atrophy may occur on the palmar side of the hand.

Carpel Tunnel Treatment

A physical examination by a qualified health practitioner, chiropractor, or physiotherapist will help differentiate carpal tunnel syndrome from other musculoskeletal difficulties. The physical examination should include one’s neck, shoulders, arms, and hands in order to rule out other underlying disorders that can mimic a true carpal tunnel disorder. Blood tests and X-rays may be used to rule out diabetes, hypothyroid issues, arthritis, fractures, and dislocation of the wrist/hand.

Conservative treatment for carpal tunnel syndrome may include lifestyle changes such as staying away from or decreasing time with the source of aggravation. In addition, treatment with a chiropractor or physiotherapist has shown benefits to patients. Acupuncture, stretches, and exercises have also been shown to help relieve carpel tunnel discomfort.  In some instances, corticosteroid injections may be used. In the most severe cases of carpel tunnel syndrome, a more invasive treatment option may be used involving the surgical release of one’s carpal tunnel.

 

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