Carpal tunnel syndrome

Carpal tunnel syndrome

Carpal tunnel syndrome is a condition that occurs when the median nerve is compressed as it passes through an opening (carpal tunnel) from the wrist to the hand. The carpal tunnel is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist. The median nerve connects with the thumb and fingers. Since the median nerve provides sensory and motor functions to the thumb and three middle fingers, there are many possible symptoms of carpal tunnel syndrome. Swelling or thickening from irritated tendons can increase pressure inside the tunnel and consequently compress the median nerve. Symptoms can include pain, weakness or numbness in the hand and wrist. Treatment options for carpal tunnel syndrome range from non-surgical treatments to carpal tunnel release surgery for the most severe cases.

Causes

Carpal tunnel syndrome often results from a combination of factors which increase pressure on the median nerve and tendons in the carpal tunnel. Other contributing factors include:

  • Trauma, injury or mechanical problems in the wrist or joint
  • Joint or bone disease such as arthritis, osteoarthritis and rheumatoid arthritis
  • Hormonal or metabolic changes, including menopause, pregnancy and thyroid imbalance
  • Changes in blood-sugar levels – this may be seen with type 1 and type 2 diabetes
  • Frequent, repetitive small movements with the hands
  • Frequent, repetitive grasping movements with the hands, such as in sports and certain physical activities
  • Overactivity of the pituitary gland
  • Fluid retention during pregnancy or menopause
  • Development of a cyst or tumor in the canal
  • Work stress

Symptoms

The following are the most common symptoms for carpal tunnel syndrome. However, each individual may experience symptoms differently. Symptoms may include:

  • Pain and/or numbness that is worse at night, interrupting sleep, or in the morning when awakening
  • Difficulty making a fist
  • Difficulty gripping objects with the hand(s)
  • Pain and/or numbness in the hand(s) at any time 
  • "Pins and needles" feeling in the fingers
  • Swollen feeling in the fingers
  • Burning or tingling in the fingers, especially the thumb and the index and middle fingers

The symptoms of carpal tunnel syndrome may suggest other medical conditions or problems. Always consult your physician for a diagnosis.

Risk factors

According to the National Institutes of Health (NIH), carpal tunnel syndrome is the most common of the entrapment neuropathies, or conditions that happen when the body's peripheral nerves are compressed or traumatized. Women are three times more likely to develop carpal tunnel syndrome, possibly because the carpal tunnel is smaller in women than in men. People with metabolic disorders such as diabetes also are at risk for carpal tunnel syndrome. This condition usually occurs in adults and is most common in patients 45 to 65 years of age, although it can occur at any age. It is also common in women during pregnancy.

Although carpal tunnel syndrome has long been associated with the repetitive motions of typing on a computer keyboard, the risk of developing the condition is three times more common in assembly-line workers in the manufacturing, sewing, cleaning and meat packing industries. The NIH further reports that a 2001 research study found that heavy computer use, even up to seven hours a day, did not increase a person's risk of developing carpal tunnel syndrome.

The multidisciplinary team of hand and wrist experts at Northwell Health Orthopaedic Institute treats carpal tunnel syndrome as well as a broad range of conditions affecting the hand and wrist areas.

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