What is Carpal Tunnel Syndrome (aka Median Nerve Entrapment)?
The carpal tunnel is a narrow tunnel through which ligaments pass to get from the wrist to the hand. The median nerve, one of the main nerves to supply the hand, also passes through this tunnel. Carpal Tunnel Syndrome occurs when the tunnel is narrowed resulting in compression of the median nerve, which leads to a lack of function of the median nerve beyond the carpal tunnel.
What causes Carpal Tunnel Syndrome?
The carpal tunnel can become narrower due to thickening of the tendon’s lining or a swelling which narrow’s the tunnel’s lining. This is commonly caused by repetitive work strain (such as typing, writing or using vibrating tools). Other causes of median nerve entrapment leading to carpal tunnel syndrome include rheumatoid arthritis, hyperthyroid disease and pregnancy.
What are the symptoms of Carpal Tunnel Syndrome?
The main symptom in Carpal Tunnel Syndrome is numbness, pins and needles and/or weakness of the hand in the distribution of the median nerve, which includes the palm, thumb, index and middle finger, and part of the ring finger. Often symptoms can be felt in both hands, with one worse than the other.
Symptoms associated with this include:
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Burning, tingling or itching (which is often relieved by shaking the hand)
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Symptoms worse in the morning, or may wake patient up at night
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Symptoms may also be aggravated by using the hand, eg when driving or writing with a pen.
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Patients may notice decreased grip strength, or difficulty doing tasks such as undoing a button
How is Carpal Tunnel Syndrome diagnosed?
If you have symptoms similar to those described above, see your doctor and tell them about it. Your doctor will ask you questions and examine your hand. He may also want to order tests, which may include Nerve Conduction Studies (a non-invasive test of the nerve) and Electromyography (a minimally invasive test of muscle function). An ultrasound may also be useful to visualise the median nerve.
How is Carpal Tunnel Syndrome Treated?
Depending on severity, Carpal Tunnel Syndrome can be managed a number of different ways.
Non-surgical treatments include:
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Wearing a splint
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Simple pain relief with medications such as ibuprofen
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Lifestyle changes (such as avoiding repetitive stress)
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Stronger medications or pain relief injections
If these measures are unsuccessful, surgery can be considered. This is a common and simple procedure which involves severing a ligament of the wrist to reduce the pressure in the carpal tunnel. It is a day-procedure (you will not have to stay over night), and only requires local anaesthetic (you will not need to be put under)
If you are interested in learning more about this topic, feel free to book an appointment with one of our friendly doctors by booking online or contacting us by phone on 8269 6000.
References:
National Institute of Neurological Disorders and Stroke 2017, Carpal Tunnel Fact Sheet, [ONLINE] Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-Sheet (Accessed 21 Jun 2018)
Emergency Care Institute New South Wales 2015, Carpal Tunnel Syndrome, [ONLINE] Available at: https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0003/273954/cts-ed-patient-factsheet-march-2015.pdf (Accessed 21 Jun 2018)
American College of Rheumatology 2017, Carpal Tunnel Syndrome, [ONLINE] Available at: https://www.rheumatology.org/Portals/0/Files/Carpal-Tunnel-Syndrome-Fact-Sheet.pdf (Accessed 21 Jun 2018)
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