Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

The carpal tunnel is a narrow passageway found on the anterior portion of the wrist.
It serves as the entrance to the palm for several tendons and median nerve.

Clinical : Carpal Tunnel Syndrome

Compression of Median nerve within the carpal tunnel can cause Carpal tunnel syndrome.
It can be caused by thickened ligament and tendon sheaths.
If left untreated, CTS  can cause weakness and atrophy of the Thenar muscles.

 Symptoms - include tingling, burning, or itching and numbness in the palm of the hand and the fingers, especially the thumb and index finger.Symptoms are often being worse in the morning.

The National Institute of Neurological Disorders and Stroke (NINDS), describe carpal tunnel syndrome (CTS) as the “most common and widely known of the entrapment neuropathies in which the body’s peripheral nerves are compressed or traumatized.”

Causes - The most common causes are thought to be:

• repetitive maneuvers
• repeated use of vibrating hand tools
• work stress
• pregnancy, for example, because of edema .
• inflammatory, degenerative, and rheumatoid arthritis

Spending too much time working on a computer keyboard and
 with a mouse can cause hand pain and numbness

• hypothyroidism, or a thyroid
• diabetes
• trauma, such as dislocation or fracture of the wrist
• structural problems in the wrist joint
• lesions in the wrist
• a cyst or tumor in the carpal tunnel
• an overactive pituitary gland
• any kind of swelling or inflammation around the tendons

Diagnosis

Self-tests for CTS include  tapping the wrist lightly to see if this produces a tingling sensation or numbness in the fingers.

Another test is to flex the wrist or hold it above the head for a minute. If there is pain, numbness, or tingling, it may mean that CTS is present.

However, these tests are not conclusive.

A primary care physician can usually diagnose CTS after asking about symptoms and examining the hand and wrist for signs of weakness in the muscles around the thumb. They will also assess how well the person can use the hand and wrist.

SPLINT

Treatment – 

• Involve the use of a SPLINT.
• Holding the wrist in dorsiflexion overnight to relieve symptoms.
• Corticosteroids injection into the carpal tunnel  can be used. 
• In severe case – surgical decompression of carpal tunnel may be required.

Self-help tips

The following may help reduce discomfort:

• Resting the hand and wrist: The more rest the hand and wrist get, the greater the chance of relieving the symptoms.
• Cold compress: Placing an ice pack on the wrist may help when the problem flares up, but ice should not be applied ice directly onto the skin
• person should take breaks so the hand and wrist have time to rest and recover.
• Occupational therapy: A therapist can teach a person how to repetitive tasks differently.
• Wrist splints: These keep the wrist in the same position and prevent it from bending. They can be worn during sleep, but also during the day if they do not interfere with daily activities. Wrist splints are available over the counter at pharmacies. A doctor or pharmacist can advise about the best one to choose.

Exercise

Here are two exercise that may help relieve the discomfort of CTS:

1. Make a fist, with the back of the hand facing down. Slide the fingers up until they are pointing straight up toward the ceiling. Repeat five to 10 times.

2. Make a fist. Open your hand and spread out the fingers, stretching them as far as possible. Repeat five to 10 times.
 As Exercises really have any benefit.