Carpal Tunnel Syndrome is a set of symptoms caused by compression of the median nerve where it passes through the carpal tunnel at the wrist along with several tendons. The median nerve controls movement and feeling in the thumb and first three fingers of the hand, and is affected through lack of blood flow. Carpal tunnel syndrome can result in pain, tingling and/or numbness in the palm of the hand and the first 3 fingers. If severe, grip strength and wrist flexion may become limited. This pain is usually worse at night and first thing in the morning as inflammation tends to collect overnight. Carpal tunnel syndrome is often confused with Thoracic Outlet Syndrome. They are not the same condition but can coexist.
What Causes Carpal Tunnel Syndrome?
Carpal tunnel syndrome is caused by pressure on the median nerve. The pressure can come from swelling, which causes lack of blood flow to the nerve. The condition is most commonly associated with repetitive use of the wrist flexor muscles, pregnancy, or direct trauma to the median nerve. Women especially are affected by this condition. Women who are pregnant tend to have increased swelling and this can irritate the median nerve. Sleeping with the wrist in a bent position at night and repetitive typing can also cause carpal tunnel syndrome. Diabetes and arthritis can also cause carpal tunnel syndrome.
Symptoms
Typically there will be tingling or numbness in the palm of the hand and the first 3 fingers. If more severe there will be weakness when trying to grip things or flex the wrist. There will not be any bruising but swelling may be present over the front of the wrist and forearm. Pain, tingling, or numbness in the thumb and first three fingers but not the little finger is often a sign of carpal tunnel syndrome.
Prognosis
Early detection and treatment are key to treating the condition, and long-term nerve damage can often be avoided with prompt treatment. Normal sensation will return to the hand and pain will ease off once pressure is relieved and blood flow is restored to the nerve. The duration of this can vary greatly depending on the cause.
The first step is to eliminate the cause of the problem. Accordingly, you should stop activities that cause pain in your wrist and rest the wrist for longer periods of time between activities. Icing the wrist, wearing a wrist splint at night, and taking non steroidal anti-inflammatory drugs to reduce swelling and help with pain are often indicated. Surgery is an option when the injury does not respond to treatment, but is generally considered to be an option of last resort.
Preventive care focuses on avoiding the repetitive movements that initially caused the condition, keeping the wrist in a neutral position, and switching hands when performing tasks. Managing diabetes and arthritis is important if they are the primary factors.
How Apex Can Help
Treatment is aimed at reducing inflammation via rest, ice, activity medication and possibly splinting in the initial stages. Later, massage, stretching and acupuncture can also be useful tools in restoring normal length-tension relationships of the muscle constricting the median nerve.
A Bauerfiend night splint may be beneficial for morning pain and numbness as it will keep your wrist in a neutral position while you sleep. If you think you might have carpal tunnel syndrome, give us a call. The health professionals at the Apex Centre will be able to treat your condition and get you back on the road to a pain-free life.
Resources
- https://en.wikipedia.org/wiki/Carpal_tunnel_syndrome
- https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603
