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Carpal Tunnel Syndrome

Carpal Tunnel syndrome,orthopaedics

The hand and the wrist bones are flexible which offer the body with support and elasticity to move objects in many ways according to their wishes. The ulna and radius of the forearm, support many of the hand’s muscles. There are 27 bones in the hand and all of them have an incredibly precise range of flexibility.

The hand can be considered in four segments:

  • Fingers
  • Dorsum
  • Wrist
  • Palm

What is Carpal Tunnel?

The carpal tunnel is a narrow, tunnel-like structure in the wrist, with the carpal (wrist) bones forming the bottom and sides and the transverse carpal ligament, a strong band of connective tissue, forming the top of the tunnel.

The median nerve, which controls sensation in the palm side of the thumb, index finger, and long fingers as well as the muscles around the base of the thumb, extends from the forearm to the hand via the carpal tunnel.

Carpal tunnel syndrome is a hand and arm condition that occurs when synovium (tissues) surrounding the flexor tendons in the wrist is inflamed and as a result, puts pressure on the median nerve.

The swelling of the synovium narrows the already-limited space within the carpal tunnel and crowds the median nerve.

Women are more liked to develop carpal tunnel syndrome than men and there are several different ailments and conditions contribute to the development of the condition, including heredity, age, medical conditions such as diabetes or thyroid gland imbalance, as well as hormonal changes caused by pregnancy.

Symptoms of Carpal Tunnel

Individuals who have developed carpal tunnel syndrome commonly have the following symptoms:

  • Pain, numbness, or tingling in the affected hand
  • The overall weakness in the hand signaled by a greater tendency to drop things
  • Unusual or strange sensation and pain going up the arm towards the shoulder
  • Shock-like sensation in the fingers – primarily thumb, index, and long fingers

Shrugging of the hand offers relaxation or relief from pain – this is often a typical explanation by the patient when they explain the pain to the Doctor.

Early diagnosis and treatment of carpal tunnel syndrome can greatly help in reducing symptoms and avoiding more permanent damage to the nerves and muscles.

Therefore, it is strongly advised to visit a physician if and individual experiences any of the symptoms or suspect carpal tunnel syndrome.

Diagnosis of Carpal Tunnel

The diagnosis of carpal tunnel syndrome is generally made upon a physical examination only. Sometimes imaging and nerve conduction studies are also needed in severe condition to quantify the problem.

After taking a full history of the symptoms and any prior injuries, the physician will examine the hand for feeling in the fingers and the strength of the muscles in the hand.

The physician might put pressure on the median nerve by bending the wrist or simply pressing or tapping on the nerve to see if symptoms worsen. If the individual has limited motion in the wrist, the physician may order x-rays to rule out other conditions.

To confirm the diagnosis and identify the best treatment option, the physician may also conduct electrical testing of the median nerve.

Treatment of Carpal Tunnel

Early diagnosis of carpal tunnel syndrome will typically respond quite well to non-operative treatment, and for most people, the condition will only worsen if left untreated.

The main objective of treatment is controlling inflammation and reducing symptoms. Operative treatment is typically a last resort after non-operative approaches have been exhausted.

  • Activity Modification: Pain is often aggravated when making certain movements with the wrist, therefore changing the patterns of hand usage to avoid activities that worsen the symptoms may be helpful.
  • Medication: Pain relief medication such as acetaminophen as well as non-steroidal anti-inflammatory medicines can significantly reduce pain and swelling.
  • Brace or Splint: The physician might recommend the use of a supportive brace or splint worn throughout the night or the day to limit the movement of the wrist and keep it in a neutral place.
  • Steroid Injections: Injecting the wrist with cortisone, a powerful anti-inflammatory medicine, might aid in decreasing pain, however, the pain is likely to return.
  • Surgery: Surgery may be an option when more-conservative treatments don’t relieve pain or numbness caused by severe carpal tunnel syndrome. The goal of surgery will be to reduce or eliminate the pressure on the median nerve by trimming the ligament that is contributing to the pressure. Options must be discussed extensively with the physician to identify the appropriate surgical procedure.

Recovery after Carpal Tunnel Surgery

Recovery after surgery depends on the initial symptoms of the patient and delay in undertaking the procedure. Surgery done properly and in time results in 100% recovery within a week.

The signs and symptoms start disappearing just after the surgery. Each patient is unique, and their recovery will depend on the treatment method prescribed by the physician.

Sometimes recovery after surgery may be delayed if the treatment is delayed till severe injury to nerve has already happened.

Hence, it is recommended that the patient should consult the physician/orthopedic specialist soon after experiencing the symptoms initially.

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