Carpal tunnel syndrome

  • Basics

    Carpal tunnel syndrome is a painful condition caused by pressure on the nerve that serves the fingers and palm. Figure 01. The carpal tunnel is a passage in each wrist that is formed by the carpal bones and the volar carpal ligament. Carpal tunnel syndrome occurs when the median nerve, which travels from the arm to the fingers, becomes compressed within the carpal tunnel. Although the tunnel usually protects the median nerve, tissues within the tunnel can become inflamed or swollen. This inflammation results in pressure on the nerve.

    Click to enlarge: Carpal tunnel syndrome (animation)

    Figure 01. Carpal tunnel syndrome (animation)

    Carpal tunnel syndrome is usually characterized by pain or tingling. Other symptoms may include numbness or weakness in your hands that may cause you to drop objects. If this weakness continues for long periods or time, it may result in permanently atrophied muscles. Some people with carpal tunnel syndrome experience intense pain that shoots up the arm to the shoulder.

    Although some medical conditions such as diabetes can increase a person’s risk for carpal tunnel syndrome, most cases are caused by repetitive motions of the hands or wrists. Carpal tunnel syndrome is most common in middle-aged people, but is rare in young people who have not yet had long-term exposure to the repetitive motions that most often cause the condition.

    Only approximately 1% of people with carpal tunnel syndrome are injured permanently. Most patients respond well to treatment. Also, many patients who are successfully treated can avoid recurrences by changing or avoiding the action or actions that led to the condition.

    Treatment varies from wearing a brace to drug therapy or surgery. Mild carpal tunnel syndrome may be effectively treated with a brace, which is usually worn overnight. This gives the wrist a chance to rest so that the swollen tissues inside the carpal tunnel can shrink, reducing pressure on the median nerve. As symptoms become more severe, drugs or surgery may be recommended.

  • Causes

    Although carpal tunnel syndrome can be caused by several medical conditions, the most common cause is overuse of the wrists due to repetitive tasks. Any condition that causes the tissues within the carpal tunnel to swell can lead to carpal tunnel syndrome. Some examples are broken or dislocated wrist bones, arthritis, thyroid imbalance, diabetes, menopausal hormone changes, and pregnancy. However, the most frequent cause is repetitive tasks that require bending of the wrists or grasping with the hands. Tasks that carry a recognized risk for carpal tunnel syndrome include typing, cutting, sewing, or playing a musical instrument. Overuse of small hand tools is often associated with this condition. Use of vibrating tools, such as a jackhammer, is also considered to be a contributor.

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