Carpal tunnel syndrome (CTS)
Carpal tunnel syndrome is a hand and arm condition that causes numbness, tingling and other symptoms. It is common during working age, when overweight or pregnant, and is found in both women than men. A number of factors can contribute to carpal tunnel syndrome, including the anatomy of the wrist, certain underlying health problems and possibly patterns of hand use.
Common carpal tunnel syndrome symptoms include:
- Tingling or numbness. Patients experience tingling and numbness in their finger, especially thumb and index, middle or ring fingers, but not little finger. Some case experience a pain in wrist or palm and extend to arm. It usually occurs while using the wrist for long periods, such as holding things, twisting the wrist or waking from sleep. And some people "shake out" their hands to try to relieve their symptoms.
- This sensation often occurs sometime while holding a thing, driving. In severe cases, the symptom will progress, and the numb feeling may become constant. Patients may experience weakness in their hand and a tendency to drop objects. This may be due to the numbness in their hand or weakness of the thumb's pinching muscles, which are controlled by the median nerve. And the palm muscle in the thumb side can become atrophied in severe cases.
Causes
Generally, the median nerve’s function is to connect sensation and controller nerve signals between forearms to hands passing through the carpel tunnel. In the hand, there is a tendon with the ligament on the top that control hand action. The lower part of hand structure consist of pieces of wrist bones.
In general, anything that irritates or compresses the median nerve in the carpal tunnel space can lead to carpal tunnel syndrome, the cause of compression such as:
- 1.The tendon and synovium are swelling or thickening because overloaded function
- 2.Acute and chronic injuries of the wrist
- 3.Occurring of hyperostosis or fat body in carpal tunnel
When the median nerve and tendons in the carpal tunnel are compressed it can cause numbness, weakness, or muscular dystrophy.
Diagnosis
The doctor will be taking a medical history and performing a physical examination to rule out other diseases that may cause similar symptoms, such as Cervical radiculopathy, neurological diseases etc.
In some case a Nerve Conduction Study (NCS), or motor power study to investigate the Carpal tunnel syndrome, might be needed.
Treatments
Carpal tunnel syndrome should be treated as early as possible after you begin to experience symptoms.
- • In case of early stages, patient should reduce using the wrist function, avoid lifting things, or bending or folding the wrists for 1-2 weeks.
- • Treatment with oral Nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease inflammation and swelling. Steroids can be injected directly into the wrist or taken by mouth to relieve pressure on the median nerve and provide immediate, temporary relief to persons with mild or intermittent symptoms. But the fascia will continuously exist.
- • Surgery. If patient symptoms are severe or persist after trying nonsurgical therapy, surgery may be the most appropriate option.
- • Supportive treatment. If patient has reduced hand and wrist function, supporting wrist with wrist splint at night can relieve pain and numbness.
How to prevent carpal tunnel syndrome
- • Reduce your force and relax your grip.
- • Take frequent breaks. If your hands and wrists have to grip strong vibrating devices, such as a drill, you should have a break every 15-20 minutes.
- • Avoid bending or twisting the wrist for a long period, such as typing a keyboard, etc.
- • Keep your hands warm if you work in a cold environment.
By Dr. Sirarat Morarat, a neurologist of Comprehensive Neurology Center, Tel. 0-2586 - 7888
