The human hand is beautifully and complexly engineered. It is designed for strong and steady grip, but also must have the dexterity to precisely manipulate small objects. Still, despite their design, resilience, and major role they play in nearly every aspect of our day-to-day lives, the hands are still susceptible to injury. And, since the 1980s, one of the most common and increasing hand-related conditions is carpal tunnel syndrome (CTS).
What is Carpal Tunnel Syndrome?
There are three major nerves within the hand (median, ulnar, and radial) which control various aspects of movement and sensation. Of these, the median nerve is responsible for feeling along the palm side of the thumb, index, middle, and half of the ring finger. The carpal tunnel is comprised of the carpal bones on the back of the hand and the transverse carpal ligament on the palm side. The tunnel is located at the base of the hand, and is the area through which the median nerve passes.
Unfortunately, the carpal tunnel is fairly rigid, so when inflammation occurs within this structure, it is unable to expand outward. Instead, the pressure builds and begins to compress the median nerve. As a result, the nerve will begin to produce worsening symptoms of pain and discomfort.
What are the Symptoms Carpal Tunnel Syndrome?
Nerve compression does not happen overnight. Rather, it builds gradually and produces initially mild symptoms that worsen over time. In the beginning, patients may complain of sensations of itching, tingling, or burning numbness in the thumb and first two fingers, particularly at night. As CTS progresses, these symptoms become more prominent throughout the day and may continue up the arm. Eventually, many will experience weakness in the hands that make performing fine motor tasks difficult.
Who gets Carpal Tunnel Syndrome?
Women, in particular, are susceptible to carpal tunnel syndrome, being three times more likely than men to receive a CTS diagnosis. Additional factors that may increase risk include:
- Occupation: Jobs like assembly line work or data entry, which require repetitive or prolonged wrist flexion, are commonly associated with CTS.
- Health Conditions: Conditions causing inflammation or nerve damage, such as rheumatoid arthritis or diabetes, may heighten risk.
- Pregnancy: Hormonal changes and fluid retention during pregnancy may contribute to carpal tunnel syndrome.
- Wrist Anatomy: The carpal tunnel is smaller in some patients than others, making the median nerve more susceptible to pressure. Likewise, deformation in the wrist due to trauma, such as fracture or dislocation, is another potential factor.
How is Carpal Tunnel Syndrome Treated?
Carpal tunnel syndrome is unlikely to improve without treatment. In fact, the condition may continue to progress and further damage the median nerve, making early intervention a necessity. Additionally, the earlier treatment begins, the less likely a patient will be to require surgery. Typical non-surgical treatment options include:
- Bracing or splinting
- Activity modifications
- NSAIDs (nonsteroidal anti-inflammatory drugs)
- Physical therapy
- Steroid injections
In more advanced cases or those for whom non-surgical methods prove ineffective, carpal tunnel release surgery may be recommended. This outpatient procedure divides the transverse carpal ligament, thereby opening the tunnel and relieving pressure. The outcome of this surgery is good for the vast majority of patients. However, hand strength returns gradually, and full recovery could take several months.
If you are experiencing the symptoms of CTS, do not delay in seeking medical treatment. Although your discomfort may seem somewhat manageable now, it is likely to worsen with time. In order to avoid nerve damage and long-term complications, contact an orthopedic specialist, like Dr. Tyson Garon at Bone & Joint Clinic of Baton Rouge, and request a consultation at your earliest convenience.