Carpal tunnel syndrome is a result of compression in the median nerve under the transverse carpal ligament at the wrist. The median nerve is present in the person’s arms and it passes through the carpal tunnel, which is a passage in the wrist. The nerve then ends in the hand. The median nerve handles the feelings and the movement of the thumb and the fingers except the little finger.

Diagnosis of carpal tunnel syndrome

Diagnosis of this condition is a combination of clinical confirmation and relevant testing. A clinical diagnosis is based on the history of the symptoms and the findings of an examination. A doctor could conduct a test called tinel sign in which he taps the palm side of a wrist or fully flexes your wrist with arms extended. They might also include the following test:

Electromyogram

In this, the doctor puts a thin electrode into the muscle to measure its electrical activity.

Imaging test

This can include X-rays, ultrasounds, or MRI scans to help to look at your bones or tissue.

Nerve conduction studies

Nerve conduction studies measure the signals in the nerves of your hand and arm, by taping electrodes to your skin.

Symptoms of carpal tunnel syndrome

The symptoms constitute the pain in the index and the middle finger. Apart from the pain symptoms, the patients might also experience numbness or tingling sensations. In some cases, which have progressed, the patients might experience muscle weakness or atrophy. Some of the symptoms of carpal tunnel include

• Tingling, itching, burning, and numbness in the thumb, palm or in the index or middle finger.
  
• Carpal Tunnel syndrome leads to weakness in the patient’s dominant hand and this also causes trouble to the patient in holding things.
  
• The syndrome causes shock-like sensation in the fingers of the patients.
  
• The patient might experience tingling sensations, moving up to the arm.
  
• Numbness in the fingers at night and tingling from hand to up to the shoulder.
  

Treatment of carpal tunnel syndrome

Conservative treatment options are utilised to avoid activities that irritate the nerve. Activities such as splinting and hand physiotherapy are also suggested by physicians. The treatment of carpal tunnel syndrome depends on the person’s symptoms. Some of the treatments employed include:

Exercise

Some exercises such as stretching and nerve gliding exercises can assist in the better nerve movement in the carpal tunnel.

Lifestyle changes

If a certain activity is causing a problem related to the carpal tunnel syndrome, then taking a break from it is advisable.

Immobilisation

A patient could wear a splint at the wrist so that the wrist does not move and the median nerve could rest.

Medications

A physician can also prescribe some steroids or anti-inflammatory drugs.

Surgery

If the above treatments do not work, then the doctor could recommend undergoing carpal tunnel release surgery. This eases the pressure on the nerve.

What causes carpal tunnel?

Predisposing medical conditions for developing the syndrome include:

• Injury or fracture of the bones in the wrist.
  
• Arthritis
  
• Obesity
  
• Pregnancy
  

Repetitive movements of the hand and wrist can cause carpal tunnel syndrome to develop. This includes placing the wrist in abnormal positions.

Prevention of carpal tunnel syndrome

A patient can reduce stress from the wrist and hands to prevent carpal tunnel syndrome. Some of the ways to achieve this include:

• Keeping straight wrists.
  
• Minimising repetitive hand movements.
  
• Switching activities to remove strain on the wrist or the hand.
  
• Wearing a splint at the night.
  
• Adjusting the body, at workplace, so the forearms are at par with a work surface.
  

Risk factors

Some of the factors, which could increase the risk of carpal tunnel syndrome are as mentioned:

• Abnormally smaller size for the bone, that constitutes the carpal tunnel
  
• Damage to the joints at the wrists or hands
  
• Mastectomy procedure
  
• Pregnancy
  
• Menopause
  
• Frequent hand and wrist movement
  

Complications of carpal tunnel syndrome

Carpal tunnel syndrome can lead to a reduction in the size and weakness at the base of the thumb. If not treated, this can further lead to permanent deformities. This can cause obstruction in the hand and palm movement for patients.

Frequently asked questions

Where is the carpal tunnel found?

Carpus means wrist and is derived from the Greek word karpos. Carpal tunnel is a passage in the wrist that connects the pillars of the arch and constitutes carpal bones and ligaments. 

What is median nerve?

The median nerve is present in the person’s arms and it passes through the carpal tunnel, which is a passage in the wrist. The nerve then ends in the hand. The median nerve handles the feelings and the movement of the thumb and the fingers except the little finger.