Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

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Carpal tunnel syndrome is the compression of the median nerve as it passes into the hand. The median nerve is located on the palm side of your hand (also called the carpal tunnel). The median nerve provides sensation (ability to feel) to your thumb, index finger, long finger, and part of the ring finger. It supplies the impulse to the muscle going to the thumb. Carpal tunnel syndrome can occur in one or both of your hands.

Swelling inside your wrist causes the compression in carpal tunnel syndrome. It can lead to numbness, weakness, and tingling on the side of your hand near the thumb.

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What causes carpal tunnel syndrome?

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The pain in your carpal tunnel is due to excess pressure in your wrist and on the median nerve. Inflammation can cause swelling. The most common cause of this inflammation is an underlying medical condition that causes swelling in the wrist, and sometimes obstructed blood flow. Some of the most frequent conditions linked with carpal tunnel syndrome are:

• diabetes

• thyroid dysfunction

• fluid retention from pregnancy or menopause

• high blood pressure

• autoimmune disorders such as rheumatoid arthritis

• fractures or trauma to the wrist

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Carpal tunnel syndrome can be made worse if the wrist is overextended repeatedly. Repeated motion of your wrist contributes to swelling and compression of the median nerve. This may be the result of:

• poor positioning of your wrists while using your keyboard or mouse

• prolonged exposure to

• vibrations from using hand tools or power tools

• any repeated movement that overextends your wrist, such as playing the piano or typing

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What are carpal tunnel syndrome symptoms?

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People with carpal tunnel syndrome initially feel numbness and tingling of the hand in the distribution of the median nerve (the thumb, index, middle, and thumb side of the ring fingers). These sensations are often more pronounced at night and can awaken people from sleep. The reason symptoms are worse at night may be related to the flexed-wrist sleeping position and/or fluid accumulating around the wrist and hand while lying flat. Carpal tunnel syndrome may be a temporary condition that completely resolves or it can persist and progress.

As the disease progresses, patients can develop a burning sensation, and/or cramping and weakness of the hand. Decreased grip strength can lead to frequent dropping of objects from the hand. Occasionally, sharp shooting pains can be felt in the forearm. Chronic carpal tunnel syndrome can also lead to wasting (atrophy) of the hand muscles, particularly those near the base of the thumb in the palm of the hand.

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Who is at risk for carpal tunnel sydnrome?

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Women are three times more likely to have carpal tunnel syndrome than men. Carpal tunnel syndrome is most frequently diagnosed between the ages of 30 and 60. Certain conditions increase your risk for developing it, including diabetes, high blood pressure, and arthritis.

Lifestyle factors that may increase the risk for carpal tunnel syndrome include smoking, high salt intake, sedentary lifestyle, and a high body mass index (BMI).

Jobs that involve repetitive wrist movement include:

• manufacturing

• assembly line work

• keyboarding occupations

• construction work.

​People employed in these occupations may be at higher risk of developing carpal tunnel syndrome.

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What is the prognosis for carpal tunnel syndrome?

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The outlook is generally excellent as carpal tunnel syndrome usually responds to the conservative measures reviewed above. Sometimes surgical operation is necessary, and residual weakness can occur.

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