Carpal tunnel syndrome happens because of pressure on your median nerve, so it is also called median nerve compression. It is a condition that causes pain, numbness, tingling and weakness in the hand and the symptoms tend to be worse at night.

 

Anatomy

 

The median nerve, which runs the length of your arm, goes through a passage in your wrist called the carpal tunnel, and ends in your hand, controls the movement and feeling of the thumb, the index finger and the middle finger, as well as transmit messages to muscles.

 

What causes carpal tunnel syndrome?

 

Carpal tunnel syndrome may be caused by pressure on the median nerve which travels through the wrist at the carpal tunnel due to an overuse injury or a repetitive motion performed by the wrist or hand. When the synovium swells, it takes up space in the carpal tunnel and, over time, crowds the nerve, and finally leads to the numbness and tingling in most of the fingers in the hand. Some frequent conditions linked with carpal tunnel syndrome are:

 

• Overuse or repetitive motion at the hand and wrist
• Fractures or trauma to the wrist
• Rheumatoid arthritis
• Thyroid dysfunction
• Diabetes
• Menopause
• Pregnancy

 

Symptoms

 

Patients may experience tingling or numbness in most of the fingers in the hand. Sometimes, the sensation may travel from the affected wrist up to the arm. And these symptoms often become worse at night. When the symptoms develop, patient may have trouble in completing some small tasks such as fastening the buttons and using chopsticks.

 

How is carpal tunnel syndrome diagnosed?

 

Carpal tunnel syndrome is usually aggravated by repetitive movements. If patients notice tingling and numbness in the fingers or hand, there are two quick self-tests that may help before the clinical examination. 

 

Phalen’s test：

 

In this test, the patient rests his or her elbows on a table and allows the wrist to fall forward freely. Individuals with carpal tunnel syndrome will experience numbness and tingling in the fingers for 30 to 60 seconds.

 

Tinel tes：

 

In this test, you may tap over the median nerve at the wrist to see if it produces a tingling sensation in the fingers.

 

A physical examination includes a detailed evaluation of your hand, wrist, shoulder, and neck to check for any other causes of nerve pressure. Some diagnostic tests including CT scans and ultrasound will also be performed to measure the nerve condition. The specialist will also check sensation to the fingers and strength of the muscles in the hand.

 

Treatment

 

For mild cases of carpal tunnel syndrome, resting the hand and wearing a splint at night might relieve symptoms. Besides, physical therapies, i.e. hot therapy, warm water treatment and extracorporeal shock wave therapy are effective to treat the symptoms of carpal tunnel syndrome without worsening inflammation or stiffness. In severe cases, the specialist may prescribe the steroids to reduce swelling in the connective tissue. Steroid injections can help temporarily relieve symptoms but will not give more long-lasting relief.
 

If symptoms persist despite nonsurgical treatment, surgical intervention is warranted. A carpal tunnel release surgery is usually done under local anaesthesia. The surgeon cuts about a small incision on the wrist and uses common surgical instruments to cut the carpal ligament and enlarge the carpal tunnel.

 

*The above information is for reference only, please consult your doctor for detail.