Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS), a condition where the median nerve is compressed by a ligament as it goes through the wrist resulting in the pain, numbness, and tingling of the hand.
Women are twice as likely to develop CTS than men.
Causes
- A common cause of Carpal Tunnel Syndrome includes repetitive movements such as flexion/extension of the wrist during activities like reading and typing.
- Other factors that may influence CTS are wrist fractures, underlying nerve dysfunctions, Rheumatoid arthritis, and diabetes.
Symptoms
Carpal Tunnel Syndrome is characterized by pain, numbness, and tingling usually felt on the palm or palmar side of the pointer, middle, and ring finger.
Other indicators include weak grip, feelings of a swelling hand, or atrophy of hand muscles.
Diagnosis
Carpal Tunnel Syndrome can be diagnosed using a patient’s history and a physical exam, sometimes an electromyography and nerve conduction velocity test is used in addition to the other diagnostic methods.
Physical Exam
- Tinel’s sign: light tapping over the nerve creates a tingling in the thumb, pointer, or middle finger.
- Phalen’s sign: patient is asked to rest elbow on a table and hold maximum wrist flexion for at least a minute, describing any sensations they feel.
Treatment
Treatment of Carpal Tunnel Syndrome is dependent on severity of CTS and preference of type of treatment. Mild to moderate cases may use a combination of more conservative treatments such as:
- Reducing the factors contributing to repetitive strain
- Wrist splints
- Ice
- Glucocorticoids
- Pulsed ultrasound
Chronic cases, for patients who’s CTS does not improve with conservative treatment within six months.
Treatments include:
- Surgery: used as a permanent treatment to decompress the median nerve either through open incision surgery or endoscopic surgery.
Prevent CTS, through minimizing aggravation and trying to keep the wrists in a natural position, is the most successful treatment.