Carpal Tunnel Syndrome

 

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is caused by the compression of the median nerve where it passes through your wrist. Starting in your forearm, your median nerve extends along the inside of your arm, through your wrist, and into the palm of your hand.

 

Where it runs through your wrist, your median nerve is housed in a narrow, rigid passageway of ligaments and bones known as the carpal tunnel. This protective structure also houses the tendons that help you bend and extend your fingers.

 

When these tendons become irritated, swollen, or inflamed, the tunnel narrows and compresses or impinges on the median nerve; long-term or repeated compression often results in CTS.

 

What are the risk factors for CTS?

While there’s no single cause of carpal tunnel syndrome, certain factors can make you more likely to develop the problem.

 

Having a small bone structure can increase your risk of CTS simply because people with smaller frames also have smaller carpal tunnels. For this reason, women are about three times more likely than men to develop CTS.

 

Other major risk factors include:

• Repetitive use
• Chronic fluid retention
• Previous wrist injury

 

Any chronic condition that directly affects your wrist, such as degenerative arthritis, can contribute to the development of CTS. Chronic diseases associated with nerve damage, including diabetes and obesity, also can lead to CTS.

 

What are CTS signs and symptoms?

Initial symptoms usually involve intermittent tingling or numbness in your thumb, index, and middle fingers. You may experience discomfort in your wrist or palm. Other common symptoms include:

• Burning, tingling, or itching in your hand
• Ongoing wrist pain or discomfort, especially after activity
• A weak grip or inability to grasp small objects

 

As carpal tunnel syndrome worsens, you may experience numbness or tingling in your arm, wrist, hand, or fingers. These sensations may even wake you at night and make you feel as though you need to shake out your hand.

 

How is CTS treated?

 

It’s important to treat CTS as early as possible so you can prevent long-term nerve damage. Initial treatment typically includes:

• Resting the affected hand
• Changing patterns of hand use
• Wearing a wrist-hand orthotic
• Having steroid injections

 

These treatments are more likely to succeed if your symptoms are mild or moderate and you haven’t had them longer than 10 months. If early interventions don’t work, you may be a candidate for surgery, which is usually performed on an outpatient basis.