Carpal tunnel is a painful, tingling hand and arm condition caused by a pinched nerve, called the median nerve, in your wrist. Nerves and tendons run from your forearm to your wrist through what’s called the carpal tunnel which is bound by bones and ligaments about the size of your thumb, and is located on the palm side of your wrist/hand. The median nerve controls movement and feeling in your thumb and first three fingers, not including your pinky, and if compressed may cause numbness, pain and weakness. Initial symptoms may be a gradual ache in your wrist which can extend to your hand or forearm, but as the symptoms persist and the pain and weakness progressively increase, possible nerve and muscle damage can occur if left untreated.
The main cause of carpal tunnel syndrome is the pressure on the median nerve in the carpal tunnel space, but typically there is no single cause for that pressure. Instead a combination of risk factors may contribute to this condition’s development such as:
- Anatomic factors– wrist fractures or dislocations can create pressure as well as bone spurs. Carpal tunnel is also more common in women due to the carpal tunnel being relatively smaller than in men.
- Nerve-damaging conditions– chronic illnesses such as diabetes and even alcoholism which can increase risk of nerve damage includes possible damage to the median nerve
- Conditions that alter the balance of body fluids– such as hypothyroidism or other thyroid disorders, obesity, menopause, kidney failure, and pregnancy. The fluid retention may increase the pressure on the median nerve.
- Inflammatory conditions– such as rheumatoid arthritis or an infection which can affect the tendons in your wrist, resulting again in pressure to the median nerve
- Smoking– reduced blood flow to median nerve
- Repetitive motion– repeated flexing of the wrist or other workplace factors such as working with vibrating tools or on an assembly line which may create harmful pressure on the median nerve or worsen existing nerve damage
For mild symptoms home care can be the best treatment. The first step would be to stop the activity causing the numbness or pain and rest the wrist longer between activities. Using ice for 10-15 minutes and taking NSAIDS (nonsteroidal anti-inflammatory drugs) help reduce the pain and swelling. And finally wrist splinting at night keeps the wrist in neutral and reduces the pressure on the median nerve. With severe cases surgery may be needed in order to cut the ligament pressing on the nerve. With either case physical therapy is a good option to help relieve the symptoms of a mild to moderate case, or improve function and increase strengthening and range of motion in the wrist after surgery.
Some preventative measures to avoid carpal tunnel syndrome include:
- Try to keep your wrist in a neutral position avoiding too much bending (flexion or extension). If using a keyboard try to keep it at elbow height or slightly lower
- Use your whole hand to pick up objects, not just your fingers
- Relax your grip, reduce the amount of force you use when working especially with typing, or prolonged handwriting
- Keep your hands warm to avoid pain and stiffness
- Take breaks, switch between hands or alternate the tasks if and when possible
We treat patients with carpal tunnel syndrome in the 34711 area!