Carpal Tunnel Syndrome

Book now

Overview

Carpal tunnel syndrome occurs when the median nerve is compressed at the wrist. The carpal tunnel is a narrow passageway made of bones and ligaments that allows the median nerve and tendons to pass into the hand.

The median nerve controls sensation and movement in the thumb, index finger, middle finger, and part of the ring finger. When pressure builds in the tunnel, it can lead to pain, numbness, and weakness in the hand.

Urban Spine and Joint

Symptoms

Symptoms often develop gradually and may include:

  1. Numbness or tingling in the thumb and fingers
  2. Pain in the wrist or hand, often worse at night
  3. Weakness in the hand or reduced grip strength
  4. Difficulty with tasks such as typing or holding objects
  5. A burning or shock-like sensation in the fingers

Symptoms may worsen with repetitive hand use or prolonged wrist positions.

Causes

Carpal tunnel syndrome occurs when pressure increases on the median nerve.

Common causes and risk factors include:

  1. Repetitive hand or wrist movements
  2. Wrist injuries or trauma
  3. Arthritis, including osteoarthritis or rheumatoid arthritis
  4. Diabetes or thyroid disorders
  5. Pregnancy or hormonal changes
  6. Obesity
  7. Genetic factors, such as a smaller carpal tunnel

Certain conditions can lead to swelling or inflammation that narrows the carpal tunnel.

Diagnosis

Diagnosis begins with a medical history and physical examination. A doctor will assess symptoms, hand strength, and sensation.

Common diagnostic tests include:

  1. Tinel’s test to check for tingling when tapping the wrist
  2. Phalen’s test to reproduce symptoms with wrist positioning
  3. Carpal compression test to apply pressure over the nerve

Additional tests may include:

  1. Nerve conduction studies and electromyography (EMG) to evaluate nerve function
  2. Ultrasound to assess the median nerve
  3. X-rays to rule out fractures or arthritis

Treatment Options

Treatment usually begins with conservative care.

Common treatment options include:

  1. Wrist splinting to reduce pressure on the nerve
  2. Activity and ergonomic modifications
  3. Over-the-counter pain medications
  4. Hand and wrist exercises or physical therapy
  5. Warm compresses

If symptoms persist, corticosteroid injections may be used to reduce inflammation.

Surgery may be recommended in severe cases. A carpal tunnel release procedure relieves pressure by cutting the ligament over the tunnel, allowing more space for the nerve.