CARPAL TUNNEL SYNDROM
Carpal Tunnel Syndrome is a common condition which causes pain and weakness in the muscles of the hand.
There is a small tunnel-shaped structure in our wrist joint which houses a nerve called the median nerve. This particular nerve is very important for functions and sensations of the muscles of the palm. Any increase in the contents of the carpal tunnel or decrease in the size of the tunnel itself can compress the nerve as it passes through the tunnel from the hand into the palm.
Causes of Carpal Tunnel Syndrome
The exact of CTS is unknown though certain medical and occupational conditions can increase risks.
- repetitive stress (like interminable hours over a keyboard!)
- pregnancy,
- oral contraceptive pills,
- underactive thyroid functions,
- diabetes
- acromegaly
- osteoarthritis
- rheumatoid arthritis,
- cardiac failure,
- trauma and fracture of wrist bone (lunate)
- premenstrual stress.
Other factors which increase the likelihood of CTS are:
- CTS affecting any family member.
- Occupations (assembly line workers, meat packers, food processors, and the like, not general office work),
- Stress,
- Obesity
- Age (40)
Symptoms of Carpal Tunnel Syndrome
- The sensation of numbness and tingling especially in the thumb, index and middle fingers.
- In early stages this sensation is more like having your hands simply “falling asleep” (in fact, only pain with the absence of this sensation makes this diagnosis unlikely!!).
- With intense pain, relief is obtained by characteristically flicking or shaking the wrist
- Weakness of the muscles of the palm
- Difficulty in making a fist
- Tendency to drop things easily
- Grasping objects becomes very difficult
- Person tends to become clumsy
- Later on, there is visible wasting of the muscles of the palm.
Commonly, the symptoms appear at night because many people sleep with bent wrists which further compresses the carpal tunnel. Simple flexing of the hand at the wrist to 90 degrees causes considerable reduction in the tunnel size.
Diagnosis of Carpal Tunnel Syndrome
Your doctor can diagnose this condition in the clinic (PHALEN’S TEST, TINEL’S TEST).
In few cases of suspicion, these investigations may be used
- Electromyography
- Nerve conduction studies
- MRI
- Ultrasonography.