carpal tunnel syndrome
If you’re feeling numbness, tingling, or weakness in your hand, consider asking your doctor to check you for carpal tunnel syndrome.
It’s caused by pressure on your median nerve, which runs the length of the arm, goes through a passage in the wrist called the carpal tunnel, and ends in the hand. The median controls the movement and feeling of your thumb, and also the movement of all your fingers except your pinky.
The carpal tunnel is narrowed as a result, usually from swelling.
It can happen due to:
Repetitive motions, like typing or any motions of the wrist that you do over and over. This is especially true of actions when your hands are lower than your wrist.
Conditions like hypothyroidism, obesity, rheumatoid arthritis, and diabetes
Pregnancy
If you have carpal tunnel syndrome and don’t get it treated, its symptoms can last a long time, get worse, and can even go away and return.
You may feel a burning, tingling, or itching numbness in the palm of your hand and thumb, or index and middle fingers.
You might first notice that your fingers “fall asleep” and become numb at night. That usually happens in In the morning, you may wake up with numbness and tingling in your hands that may run all the way to your shoulder.the evening because of the relaxed position of your hand and while sleeping.
becomes more severe, you may have less grip strength because the muscles in your hand shrink. Pain and muscle cramping will also become worse.
The median nerve begins to lose function because of the irritation or pressure around it. This leads to:
Slower nerve impulses
Loss of feeling in the fingers
A loss of strength and coordination, especially the ability to use your thumb to pinch
You could end up with permanent muscle damage and lose function in your hand.
Electrophysiological tests may include:
Nerve conduction studies. These tests measure the signals travelling in the nerves of your hand and arm and can detect when a nerve is not conducting its signal effectively. Nerve conduction studies can help your doctor determine how severe your problem is and help to guide treatment.
Electromyogram (EMG). An EMG measures the electrical activity in muscles. EMG results can show whethTreatment
Although it is a gradual process, for most people carpal tunnel syndrome will worsen over time without some form of treatment. For this reason, it is important to be evaluated and diagnosed by your doctor early on. In the early stages, it may be possible to slow or stop the progression of the disease.er you have any nerve or muscle damage.
Nonsurgical Treatment
If diagnosed and treated early, the symptoms of carpal tunnel syndrome can often be relieved without surgery. If your diagnosis is uncertain or if your symptoms are mild, your doctor will recommend nonsurgical treatment first.
Bracing or splinting. Wearing a brace or splint at night will keep you from bending your wrist while you sleep. Keeping your wrist in a straight or neutral position reduces pressure on the nerve in the carpal tunnel. It may also help to wear a splint during the day when doing activities that aggravate your symptoms.
Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications such as ibuprofen and naproxen can help relieve pain and inflammation.
Activity changes. Symptoms often occur when your hand and wrist are in the same position for too long—particularly when your wrist is flexed or extended.
Nerve gliding exercises. Some patients may benefit from exercises that help the median nerve move more freely within the confines of the carpal tunnel. Specific exercises may be recommended by your doctor or therapist.
Steroid injections. Corticosteroid, or cortisone, is a powerful anti-inflammatory agent that can be injected into the carpal tunnel. Although these injections often relieve painful symptoms or help to calm a flare up of symptoms, their effect is sometimes only temporary.
If nonsurgical treatment does not relieve your symptoms after a period of time, your doctor may recommend surgery.
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