This condition often occurs when the median nerve, which provides feeling to the thumb, index and middle fingers, as well as a portion of the “ring” finger and several muscles in the hand, malfunctions as a result of pressure and subsequent swelling.
The median nerve is located in the carpal tunnel – a narrow passage inside the wrist. In this tunnel, the nerve is accompanied by nine tendons and is covered with a tight ligament called the transverse ligament. CTS results when the membranes, which lubricate the tendons as they glide in the tunnel, begin to swell.
Carpal Tunnel Syndrome is a repetitive strain condition – most often resulting from a constant, repetitive motion associated with a job. It is most often diagnosed between the ages of 40 and 60. Symptoms can range from mild numbness and tingling on the palmar surface of a finger, to a pain that radiates up to the shoulder. If left untreated, symptoms will usually worsen – affecting wrist, hand, or finger movement, reducing grip strength, and disrupting sleep.
Risk Factors
Those most likely to suffer from CTS include people with occupations that entail repetitive tasks with the hands such as keyboard operators, assembly line workers, typists, barbers, musicians, and drivers. Also at risk are labor workers using vibrating tools such as jackhammers, chain saws, chippers, grinders, drills and sanders.
Women are diagnosed with CTS three times more often than men. Individuals with hormone-related conditions such as pregnancy, breastfeeding, menopause, hypothyroidism, and excess growth hormones are at risk. And certain medications can increase risks as well, such as birth control pills, high blood pressure drugs, and cortisone pills or shots. Some medical conditions may also increase the likelihood of an individual to suffer CTS – including arthritis, diabetes, Raynaud’s disease and tumors and cysts in the carpal tunnel.
Genetics may also play a role, as inheriting a narrow carpal tunnel can increase a person’s chance of developing CTS.
Treatment
Before determining the most effective treatment for CTS patients a number of tests may be performed. Among the simple tests developed for the diagnosis of CTS is a Tinel’s Sign test, which involves a few firm taps on the patient’s wrist in order to determine if it sends an electric shock feeling into their hand. A Compression Test is another simple test that involves the bending of the patient’s wrist in order to have the thumb positioned down as closely to the forearm as it can go – holding for a brief period and determining if tingling or numbness results in the hand.
Other tests may involve x-rays, a computed tomography (CT) scan, or a magnetic resonance imaging (MRI) scan, in order to more precisely identify the cause of a patient’s CTS and any other problems that are either resultant of the condition, or responsible for prompting the condition.
Generally, this condition can be treated with non-invasive methods if diagnosed early, including a period of rest from the repetitive activity, and the use of Ibuprofen or Advil to ease pain and reduce inflammation. In more severe cases, a minimally invasive surgical procedure called an Endoscopic Carpal Tunnel Release is performed to address more severe or chronic cases of carpal tunnel syndrome non-responsive to conservative treatment.
Rehabilitation
After a period of rest, patients are encouraged to begin a series of stretching exercises to improve range of motion and grip strength. Depending on the treatment and severity of the condition, the resumption of daily activities and work may range from several days to several weeks. Though, the chance of a recurrence is minimal and complications extremely rare.