Paediatric Rheumatology, Hand Surgery, Rheumatology, Orthopaedic Surgery, Neurosurgery

Carpal tunnel syndrome

Introduction to Carpal tunnel syndrome

Carpal tunnel syndrome is a condition that causes numbness, tingling and sometimes pain in the hand and fingers.

Written by Doctify Team 27/04/2020

What is Carpal tunnel syndrome?

Carpal tunnel syndrome is a condition that causes numbness, tingling and sometimes pain in the hand and fingers. It is caused by compression of the median nerve that runs through the wrist, affecting around 5 women per 100 and 3 men per 100 at some point during their lifetime. Those aged 40-65 are most likely to be affected. In some individuals, especially those under 30 years old, the condition may spontaneously resolve within 6 months. In other cases, medical or surgical treatments are options.

What causes Carpal tunnel syndrome?

The carpal tunnel is a normal anatomical space in the wrist, through which the median nerve passes. This nerve innervates muscles in the hand and provides sensation to parts of the hand. In carpal tunnel syndrome, this space is compressed. Predisposing factors include diabetes, obesity, pregnancy, hypothyroidism and genetic factors. It may also arise from injury to the wrist.

Carpal tunnel

What are the symptoms of Carpal tunnel syndrome?

Carpal tunnel syndrome can affect one or both hands, causing a change in sensation and possibly pain. The condition may also cause weakness and reduce manual dexterity. It develops gradually, with the middle finger, index finger and thumb being worst affected. This is because the median nerve, which is compressed in carpal tunnel syndrome, provides sensory innervation to these fingers. However, in some cases, the whole hand or arm may be affected. Symptoms are typically worse throughout the night but may be present during the day as well.

How is Carpal tunnel syndrome treated?

Treatment aims to alleviate symptoms and prevent the disease from worsening. Things you can do to help yourself include resting your hand, using an ice pack and avoiding exercises that make your symptoms worse.

Medical treatment includes injections of steroids directly into the carpal tunnel. Injection is usually preferred to oral steroid use because it is more effective and is associated with fewer side effects. Other medications include non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen, although these have side effects associated with long term use.

Wrist splints can reduce pressure on the median nerve and are particularly useful at night. If these strategies do not alleviate your symptoms, carpal tunnel releasing surgery may be considered. This endeavours to increase the tunnel space and thus relieve pressure on the median nerve.

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