Conditions

Carpal Tunnel Syndrome

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Carpal tunnel syndrome is a compression of the median nerve. It is one of the most common problems affecting the hand.

It causes numbness and tingling in the hand and occurs when there is increased pressure on the nerve called the median nerve. This nerve provides sensation to the thumb, index and middle fingers and to half of the ring finger but rarely does it affect the baby finger.

If you have a job in which you use repetitive finger use you are at higher risk of getting carpal tunnel syndrome.

Causes:

Pregnancy

Wrist fracture and dislocation

Hand or wrist deformity

Diabetes

Alcoholism

A mass in the carpal tunnel

Thyroid disorder

High blood pressure

Autoimmune disease such as Rheumatoid Arthritis

Symptoms:

Early symptoms include numbness at night

Tingling or pain in the fingers or decreased feeling in the fingertips

Difficulty handling small objects

Holding a book is difficult

Writing and using a computer keyboard

Weakness in hand

Inability to to perform tasks that require delicate motions such as buttoning a shirt

Dropping objects

As carpal tunnel syndrome advances your symptoms become worse and are more constant.

Diagnosis:

Your Doctor will take a detailed history of you symptoms and will examine your hand.

He may request certain tests to determine if you have carpal tunnel syndrome such as:

- Tinel's Sign, your Doctor taps over the median nerve at the wrist to see if it produces a tingling sensation

- Wrist flexion test (or Phalen test). In this test, the patient rests his or her elbows on a table and allows the wrist to fall forward freely. Individuals with carpal tunnel syndrome will experience numbness and tingling in the fingers within 60 seconds. The more quickly symptoms appear, the more severe the carpal tunnel syndrome.

- X-rays of your wrist

- Electromyography and nerve conduction studies. These tests determine how well the median nerve is working.

Management:

Non surgical treatments are tried first using nonsteroidal anti-inflammatory drugs such as ibuprofen. You will also probably have to wear a wrist splint at night. Cortisone injections may be administered but they will only provide temporary pain relief.

If none of these treatments help, you may require surgery which will achieve nearly complete relief of all symptoms.