Carpal Tunnel Syndrome:

What causes it ?

Carpal tunnel syndrome is a condition that results when one of the nerves (the median nerve) going down your arm to the hand stops working properly. This is generally because there is too much pressure on the nerve as it runs through a narrow opening in the wrist called the 'carpal tunnel'. The carpal tunnel is indeed a tunnel with the bones of the wrist forming the roof of the tunnel, the floor of the tunnel being made up of fibrous bands and tendons and the middle being the place the blood vessels and nerves occupy. If the tunnel becomes compressed, the median nerve is trapped and as a consequence symptoms occur in the hand.

Symptoms:

Commonly people develop pins and needles in the wrist and hand which is more severe in the thumb, index and middle fingers and is often worse at night. These symptoms may occasionally extend into the arm and to the other fingers. The symptoms can progress to numbness in the affected areas and indeed sometimes to weakness of the hand muscles, particularly those in the thumb.

Causes:

Carpal tunnel syndrome is more common in women and may affect either hand. Usually there is no cause, but the syndrome is more common under certain circumstances:

Repetitive use of the wrists, such as in typing
Pregnancy
After fractures of the wrist
Rheumatoid Arthritis
Underactive thyroid gland – hypothyroidism
Excessive growth hormone production – acromegaly
Severe kidney failure
Use of the oral contraceptive pill

Diagnosis:

Usually the diagnosis is made solely on the basis of the history (the symptoms) and a simple examination of the wrist and hand. Sometimes your doctor may refer you for an electromyelogram (EMG). In this, small electric currents are passed into the median nerve above the wrist and the speed of conduction to the hand is measured. If the nerve is trapped the electrical impulses are slower than expected and the diagnosis can be confirmed.

Treatment Options:

Painkillers - may help with the pain but they do not cure the problem
Physiotherapy can help, particularly during pregnancy (when the symptoms will hopefully settle after the birth of the child) and other conditions such as hypothyroidism when treatment for this underlying complaint will lead to resolution of the carpal tunnel symptoms.
Injections injections of steroids by your doctor may reduce or eliminate the symptoms.
Surgery if the above measures fail and problems become severe, surgery may be considered as an option. A small incision is made in the wrist and the sheath which compresses the nerves is simply cut, relieving the pressure on the nerve. This is successful in over 50% of people treated.

Disclaimer: This page is for informational purposes only and should not be considered as medical advice or substituted for professional advice. Always consult your doctor with your questions and concerns.