Carpal Tunnel Syndrome

What is it?

Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. The condition occurs when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the wrist. 

In most patients, carpal tunnel syndrome gets worse over time, so early diagnosis and treatment are important. Early on, symptoms can often be relieved with simple measures like wearing a wrist splint or avoiding certain activities. If pressure on the median nerve continues, however, it can lead to nerve damage and worsening symptoms.

The symptoms of carpal tunnel syndrome include:

• Numbness

• Pins and needles

• Pain, particularly at night

• Darting pains from the wrist

• Radiated or referred pain into the arm and shoulder

• Weakness of the hand

• The little finger and half of the ring finger are unaffected.

Mechanism of Injury

In some cases the cause cannot be found. Sometimes there is a combination of factors, such as:

• Arthritis – various types of arthritis, especially rheumatoid arthritis, can cause inflammation and swelling

• Pregnancy – the hormones associated with pregnancy cause general fluid retention, which can compress the nerve. Carpal tunnel syndrome triggered by pregnancy usually goes away soon after birth

• Wrist fractures – bone fragments can irritate the tenosynovium or reduce the amount of space in the carpal tunnel

• Congenital factors – some people have a smaller carpal tunnel than others

• Overuse injury – the tendons in the carpal tunnel can become irritated and inflamed by awkward postures or repetitive hand movements.

Common Management Techniques

You cannot ‘work through’ carpal tunnel syndrome. At first, the pain and stiffness may be slight. But they may increase until your hand hurts all the time. You can suffer permanent damage if the cause is not addressed. 

Conservative treatments can include:

• Plenty of rest for the affected hand

• Physiotherapy

• Wearing splints on the affected wrist and hand at night 

• Diuretic medications to reduce your body’s retention of fluid by increasing the amount of urine passed

• An injection of local anaesthetic and a corticosteroid medication into the affected area to reduce the swelling.

Surgery is one treatment option for carpel tunnel syndrome, but in most cases can be avoided with a course of Physiotherapy and medications. 

Prognosis

Most patients will recover completely if they follow the recommended treatment plan for Carpal Tunnel Syndrome. You can help prevent this condition by stretching before any physical activity and performing regular exercises to strengthen and stretch the muscles in the arms.