What is carpal tunnel syndrome?
Carpal tunnel syndrome (CTS) happens when your median nerve, a main nerve that runs from your forearm into the palm of your hand, becomes compressed at your wrist in the carpal tunnel passageway.
What causes carpal tunnel syndrome
Often the reason for the squeezing of your median nerve is not known, other than the tunnel becomes narrowed or tissues swell inside your carpal tunnel.
Your carpal tunnel is narrow and rigid. It is made up of ligament and bones. Tendons also pass through the carpal tunnel and if they become swollen they can reduce the space in your carpal tunnel, leading to your median nerve getting squeezed and sometimes injured.
There are risk factors that increase your likelihood of acquiring carpal tunnel syndrome including;
- Heredity - if have a parent or sibling with CTS
- Pregnancy – causes hormonal changes
- Medical conditions – thyroid problems, rheumatoid arthritis, diabetes and obesity
- Previous wrist injury
- Repetitive work
- Being female
What are the symptoms of carpal tunnel syndrome?
Your median nerve is responsible for the sensation and movement in your hands. When trapped it can cause;
- Hand, finger or arm pain or ache
- Hand numbness
- Tingly thumb and fingers
- Weak thumb
- Hand clumsiness including difficulty gripping and a loss of manual dexterity.
These symptoms of CTS often start slowly and they may come and go. Often, they are worse at night.
How is carpal tunnel syndrome diagnosed?
If you think you may have CTS you should see your doctor sooner rather than later. Early diagnosis and treatment may prevent permanent damage to your median nerve.
Your doctor will consider your medical history and undertake a comprehensive clinical examination. They may perform;
- Tinel's test – this test involves tapping your median nerve at your wrist to find out if you have a tingling response in one or more of your fingers
- Phalen's test – you’ll be asked to put the backs of your hands together and bend your wrists. It is to see if you have tingling of your fingers
- Electromyography - electrodes are placed on your forearm and an electrical current is passed through to measure the speed and efficiency of the message transmission through your median nerve
Treatment options for carpal tunnel syndrome
Treatment of your carpal tunnel will be based on its severity. These include;
- Non-surgical treatments – for mild CTS
- Wrist splints may help immobilise your wrist
- Steroid injections are used to reduce the swelling around your nerve and to relieve your symptoms
Carpal tunnel release surgery – if non-surgical treatments aren’t successful, or if there is a chance of permanent nerve damage, surgery will be recommended.
Also known as carpal tunnel decompression, this surgery is a short, day case procedure performed under local anaesthetic. The operation takes less than half an hour and involves your surgeon making a small incision in your hand and cutting your carpal ligament (your carpal tunnel roof) so that it doesn’t put pressure on your median nerve any more.
Carpal tunnel release surgery is a common procedure and will usually cure the problem.