Carpal tunnel syndrome (CTS) is an ailment affecting the wrist and hand. The nerve controlling feeling and movement in the wrist and hand involved in carpal tunnel syndrome is the median nerve. It lies in a passage in the wrist called the carpal tunnel.
In CTS, the tunnel becomes narrow because of swelling in the wrist. The smaller tunnel squeezes the median nerve, which causes pain and other symptoms.
Moving the hand and wrist repeatedly in the same way, such as typing, writing, and using a computer mouse, can cause CTS. Some occupations such as transcriptionists, cashiers, butchers, and janitors have an increased risk of CTS. Pregnant women often get CTS because their hormones change and they retain fluid. Several illnesses, for example, muscle and bone disorders, underactive thyroid (hypothyroidism), and diabetes, can also increase risk of CTS.
In the wrist, hand, and fingers, CTS causes pain, tingling, numbness, and weak grip (a tendency to drop something). Symptoms often improve when the hand is wrung or shaken. Some people feel discomfort in the upper arm and shoulder.
Symptoms often worsen at night and can interfere with sleep.
The health care provider examines the wrist, and to cause symptoms, will tap it over the median nerve and will bend it and hold it there for a few seconds. Special tests (EMG) to check the wrist’s nerves and muscles may also be done.
Treatment involves two steps. The first is a lifestyle change: stop doing whatever caused CTS. This change may be hard if it involves a job, but talk to your employer. Sometimes simple changes, such as using a wrist pad while typing so your wrist is in a better position, help. A physical therapist or occupational therapist can suggest ways to do things differently.
The second step is to take pressure off the median nerve. Medicine, wrist splints, and surgery are usually used. A wrist splint at night is best, but some people wear a splint during the day. Pills give relief for a short time by decreasing inflammation. Medicine can also be injected into the wrist and can help for a longer period.
Surgery to make more room for the nerve is the best way to reduce pressure on the nerve when other treatments are ineffective. With surgery, you usually get better quickly, but you should rest your wrist for at least 6 weeks to promote healing and avoid new symptoms.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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