Carpal Tunnel Syndrome (CTS) is a common problem affecting hand function, caused by compression of the peripheral nerve, the median nerve, at the wrist. It most often occurs when the median nerve in the wrist becomes inflamed after being aggravated by repetitive movements, such as typing on a computer keyboard, talking on the phone (holding phone to the ear), texting or playing the piano. It also affects professional artists (sculptors, printmakers, violinists) or any job requiring long-term repetitive motion of the wrist (jackhammer use, certain factory positions).
The carpal tunnel is formed by the bones, tendons and ligaments that surround the median nerve. Since the median nerve supplies sensation to the thumb, index, and middle finger and part of the ring finger (digits one through four), and provides motion to the muscles of the thumb and hand, CTS sufferers notice numbness, pain, and weakness in these areas.
Common Symptoms Hand and wrist pain A burning sensation in the middle and index fingers Thumb and finger numbness An electric-like shock through the wrist and hand
Common Causes of CTS Diseases or conditions that may increase your chances of developing CTS include broken or dislocation of wrist bones, pregnancy, diabetes, thyroid problems, menopause and/or obesity. Repetitive and forceful grasping with the hands, repetitive bending of the wrist may also contribute. Any repetitive motions that cause significant swelling, thickening or irritation of the membranes around the tendons in the carpal tunnel can result in pressure on the median nerve, disrupting transmission of sensations from the hand up to the arm and to the central nervous system.
Diagnosing CTS X-ray: To look at the bones of the wrist, determine if any abnormalities may contribute to CTS EMG/NCS : These tests show how the nerves and muscles are working together. They measure the electrical impulse along nerve roots, peripheral nerves and muscle tissues.
Conservative (Nonsurgical) Treatments The main purpose of treatment is to reduce or eliminate repetitive injury to the median nerve. In some cases, CTS can be treated with immobilizing the wrist in a splint to minimize or stop pressure on the nerve. If that does not work, some patients may benefit from anti-inflammatory medications, icing the wrist or possible injection in the wrist to reduce swelling. Specific hand and wrist exercises may be helpful; rest may be helpful. Adjusting your environment to minimize or eliminate aggravating factors may be helpful.
Surgical Treatment Only a small percentage of patients require surgery. Factors leading to surgery include the presence of persistent neurological symptoms and lack of response to conservative measures. If you experience severe pain that cannot be relieved through rest, rehabilitation or nonsurgical management, you may be a candidate for one of several surgical procedures that can be performed to relieve pressure on the median nerve. The most common procedure is called carpal tunnel release, which can be performed using an open incision or endoscopic techniques.