Carpal tunnel syndrome is a condition of the hand and arm which causes tingling, numbness and other symptoms to develop in these regions. Carpal tunnel syndrome affects roughly 1 out of every 20 people in the United States. While both men and women are affected by this condition, females are three times as likely as men to develop carpal tunnel syndrome. This may be due to the size of the carpal tunnel itself which can be smaller in women than men.
The carpal tunnel is a narrow passageway found on the bottom side of the wrist. This tunnel provides protection for the median nerve, along with the 9 tendons that bend the fingers. The median nerve controls movement and sensation in the first three fingers and thumb. If this nerve becomes pinched or compressed, the result is tingling, numbness, pain or weakness in the hand – referred to as carpal tunnel syndrome.
Causes of Carpal Tunnel Syndrome
Carpal tunnel syndrome develops as a result of anything that compresses, crowds or irritates the median nerve located in the carpal tunnel space. Oddly enough, many patients do not know the cause of their carpal tunnel syndrome. Unlike other conditions affecting the cartilage, muscles, and tendons, carpal tunnel syndrome is rarely identified because of one single event or activity. Instead, carpal tunnel syndrome often develops as a result of a number of factors.
Factors that can increase your risk of developing carpal tunnel syndrome include:
- Anatomic factors like a wrist fracture or dislocation
- Nerve-damaging conditions like diabetes
- Inflammatory conditions such as rheumatoid arthritis
- Fluid retention, (common during pregnancy or menopause) which can increase pressure in the carpal tunnel.
- Work factors such as doing the same repetitive hand movements over time or using vibrating tools. These activities may lead to stress or injury to the carpal tunnel.
- Gender – women are more likely to develop carpal tunnel syndrome, which has been attributed to the relatively smaller size of the carpal tunnel area in women compared to men.
Symptoms of Carpal Tunnel Syndrome
Typically, the first thing people experience with carpal tunnel syndrome is a numbness or tingling in the hands. This numbness comes and goes, and can even awaken people from sleep (we sometimes sleep with our wrists in uncomfortable positions, only noticing it when awakened by the pain.) In addition, carpal tunnel syndrome can go away on its own, or persist with no warning.
Some individuals with carpal tunnel syndrome will also notice sharp, shooting pains that extend along their arms. If untreated, burning sensations in the hand, along with decreased grip strength can result.
Treatment Options for Carpal Tunnel Syndrome
The treatment for carpal tunnel syndrome is dependent on the severity as determined on a case by case basis. The most effective solution often lies in a change of habits. Individuals whose carpal tunnel syndrome has developed as a result of doing repetitive exercises or motions can start by changing these habits to diminish symptoms.
For other patients, the key to treating carpal tunnel syndrome lies in first treating the underlying cause, which may be another condition such as arthritis or diabetes. With treatment of the underlying source, the symptoms of carpal tunnel syndrome will usually improve as well. Other causes, like pregnancy, will eventually resolve on their own, causing discomfort for a brief amount of time.
Other nonsurgical treatments for carpal tunnel syndrome may include medications such as nonsteroidal anti-inflammatory drugs or corticosteroids, steroid injections, physical therapy and yoga.
For patients that do not respond to conservative treatment methods, chronic pressure on the nerves around the wrist may necessitate surgery to achieve pain relief. Surgery is a last resort and is only recommended when all other options have been exhausted.
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