Carpal Tunnel Syndrome

Carpal Tunnel Syndrome – Condition causing Pain/Numbness/Tingling Sensation

Carpal tunnel syndrome or CTS, is a common condition causing pain, numbness and a tingling sensation in the fingers and hand which may affect the working of a person’s wrist. The word carpal is derived from the word carpus which means wrist and is taken from the Greek word karpos.

In medical terms, the carpus is referred to an assembly of eight small bones which lie side by side in the wrist, in two rows, that join the forearm to the hand and the tunnel is a narrow passageway for nine tendons and one nerve called the median nerve which lies in the middle of the forearm and the wrist passing from the forearm to the hand.

This passageway is on the carpal bones and roofed by a strong ligament, known as the flexor retinaculum. In CTS condition, a group of symptoms take place simultaneously and it is called a syndrome. The median nerve in the case of CTS get pressed or pinched within the narrow tunnel producing symptoms of pain, numbness and a sensation of pins and needles in the hand and these symptoms summed together is known as carpal tunnel syndrome.

Caused – Compression of the Nerve/Median Nerve

Usually this condition develops gradually and begins to get worse atnight which tends to affect the thumb, index finger, middle finger and part of the ring finger.

Besides these, other symptoms may include paraesthesia – pins and needles sensation, thumb weakness and dull ache in the hand or arm. As this condition progresses, the person may also experience a weakened grip in the affected hand and fingers together with a loss of muscle mass on the outer side of the hand and at time the pain may also affect beyond the wrist and the forearm.

Carpal tunnel syndrome is caused by compression of the nerve which controls the sensation and movement in the hand or the median nerve. It is not clear why the median nerve tends to get compressed though there are a few incidents which may increase the risk of developing CTS such as – a family history of CTS, strenuous, repetitive work with the hand, injuries to the wrist, pregnancy - up to around fifty percent of pregnant women tend to develop CTS and other health condition like diabetes and rheumatoid arthritis.

Durkan Test/Nerve Conduction Velocity Test

In some cases CTS disappear without any treatment or with some simple self-care measures. In other cases, for the treatment of CTS patient, the doctor will check the patient’s history and examine for signs of median nerve neuropath by performing the Durkan Test and check for presence of the Tinel’s sign, the pins and needles sensation which is a positive sign of CTS. A nerve conduction velocity test – NCV may also be recommended to confirm the diagnosis.

When the diagnosis is confirmed, there are various treatment options some of which are splints and braces which are advised especially at night in order to support the wrist. Physiotherapy and exercises are recommended where the patient is taught to exercise in order to tone the muscles of the upper limb together with specific exercises to treat CTS which can reduce the severity of the pain.

Surgical release of the carpal tunnel is also done where the retinaculum is divided to create more space for the nerve in case of patients for whom the conservative therapy does not give the desired result.