What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a painful condition of the hand and wrist. It is caused by the median nerve, which runs from the forearm into the hand, being pressed or squeezed at the wrist.
Carpal tunnel syndrome is a common condition. It is thought to affect about 4 out of every 100 people in the United States and cost several billion dollars per year in time lost from work and in medical costs.
What Causes Carpal Tunnel Syndrome?
The carpal tunnel is a narrow space in your wrist. It has a ceiling, floor, walls, an entrance, and exit. The "walls" and "floor" are made up of bones. The carpal ligament is the tough "ceiling" of the carpal tunnel.
Running from the forearm to the hand and through the carpal tunnel is the median nerve, which controls some of your hand muscles and allows you to feel sensations with your hand. Several tendons also pass through the carpal tunnel.
In a normal wrist, there is adequate room in the carpal tunnel for both the tendons and the median nerve. But the carpal tunnel and the space allowed for the median nerve and tendons cannot get bigger, because the bones and ligaments that form the tunnel will not stretch. Therefore, anything that adds to this space will compress the tendons and median nerve.
As the median nerve is squeezed, less blood and nutrients flow to it. Without these essential nutrients, it becomes damaged and is unable to function normally. This results in carpal tunnel syndrome.
Carpal tunnel syndrome is often caused by a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself.
Who's at Risk for Carpal Tunnel Syndrome?
Women are three times more likely than men to get
carpal tunnel syndrome. For both men and women, the risk increases as they age.
Several other groups of people are at increased risk for developing carpal tunnel syndrome. For example, people who perform assembly-line work -- manufacturing; sewing; finishing; cleaning; and meat, poultry, or fish packing -- are at increased risk. In fact, carpal tunnel syndrome is three times more common among assemblers than among data-entry personnel. People who use vibrating hand tools, such as jackhammers or chainsaws, are also at increased risk.
Other risk factors for carpal tunnel syndrome include:
- Trauma or injury to the wrist that causes swelling, such as sprain or fracture
- Certain medical conditions, such as hypothyroidism, rheumatoid arthritis, diabetes, and systemic lupus erythematosus (lupus)
- Hormonal changes, such as with pregnancy or menopause
- Alcohol abuse
- Obesity (see BMI Calculator to find your ideal weight).
Symptoms of Carpal Tunnel Syndrome
Symptoms of carpal tunnel syndrome usually start gradually, with pain, tingling, weakness, or numbness in one or both hands radiating up the arm. These symptoms usually begin at night.
As symptoms worsen, people might feel tingling during the day, and decreased grip strength may make it difficult to form a fist, tie shoes, pick up small objects, or perform other manual tasks.
Diagnosing Carpal Tunnel Syndrome
When diagnosing
carpal tunnel syndrome, a healthcare provider will begin by asking a number of questions and performing a physical exam. If there are several possibilities for a person's symptoms, he or she may also recommend certain tests to look at how the median nerve is functioning. The healthcare provider will also consider a number of other conditions that share symptoms with carpal tunnel syndrome before diagnosing the condition.
Treatment for Carpal Tunnel Syndrome
Once a diagnosis has been made, the healthcare provider will either recommend a non-surgical option or surgery for treating carpal tunnel syndrome.
All treatment options are focused on relieving pressure from the median nerve. The specific treatment your healthcare provider recommends will depend on:
- Your current symptoms
- How long you have had them
- What is causing your symptoms
- What was found during the physical exam and other tests
- What has been tried in the past.
Non-surgical options include:
- Rest
- Splinting the wrist
- Activity modifications
- Medications, such as steroid injections
- Exercises (see Carpal Tunnel Exercises)
- Physical therapy.
Surgery may also be recommended. There are two types of carpal tunnel surgery:
Early diagnosis and treatment of carpal tunnel syndrome are important to avoid permanent damage to the median nerve.
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