Carpal tunnel syndrome describes an irritation of the synovial membranes around the tendons in the carpal tunnel. This inflammation results in in pressure on the median nerve. The median nerve travels from the forearm into the hand through a 'tunnel' in your wrist. The bottom and sides of this tunnel are formed by wrist bones and the top of the tunnel is covered by a strong band of connective tissue or ligament. This tunnel also contains nine tendons that connect muscles to bones and bend your fingers and thumb. These tendons are covered with a lubricating membrane called synovium which may enlarge and swell under some circumstances. If the swelling is sufficient it may cause the median nerve to be pressed up against this strong ligament which may result in numbness, tingling in your hand, clumsiness or pain, all classic signs of carpal tunnel syndrome.
Signs and Symptoms of Carpal Tunnel Syndrome
- Numbness and tingling in the hands
- Decreased sensation in the thumb, and fingers
- Tingling over the wrist
- Pain when holding the wrist in a bent position for a period of time
- Positive nerve conduction test (determines the pressure on the median nerve)
Causes of Carpal Tunnel Syndrome
Carpal tunnel syndrome can be caused by anything that irritates the synovial membranes around the tendons of the hands and in turn causes pressure on the median nerve. Some common causes include:
- Repetitive grasping with the hands
- Repetitive bending of the wrist
- Increases in the intensity and duration of exercise (racket sports are common) Improper and ill-fitted equipment
- Broken or dislocated bones in the wrist which produce swelling
- Arthritis, especially the rheumatoid type
- Tthyroid gland imbalance
- Hormonal changes associated with menopause
Treating Carpal Tunnel Syndrome
R.I.C.E is the first line of treatment for carpal tunnel syndrome. Rest, Ice, Compression and Elevation are all proper treatment plans. Mild cases may be treated by applying a brace or splint which is usually worn at night and keeps your wrist from bending. Resting your wrist allows the swollen and inflamed synovial membranes to shrink, and it relieves the pressure on the nerve.
Anti-inflammatories can help reduced inflammation and pain. In more severe cases, your doctor may recommend a cortisone injection. This medicine spreads around the swollen synovial membranes surrounding the tendons and shrinks them, which relieves the pressure on the median nerve. The effectiveness of non-surgical treatment is often dependent on early diagnosis and treatment. In patients who do not gain relief from these non-surgical measures it may be necessary to perform surgery.