What is Carpal Tunnel Syndrome?

In order to gain a clear understanding of Carpal Tunnel Syndrome (CTS), it is beneficial to understand the structure of the anatomy involved. Carpal Tunnel symptoms include hand and wrist pain. The carpal tunnel is actually just that – a tunnel or a very narrow passageway that is located in the joint of the wrist causing hand pain.  A total of nine different tendons as well as the median nerve run through the tunnel and, in doing so, they support and allow for proper functioning of how the index-, middle-, part of the ring-finger, as well as the thumb move and experience sensation. Interestingly, a different nerve controls the pinky finger.

When you flex your muscles in such a way as to cause your fingers to bend downward toward the palm, the flexor tendons slide through the narrow passageway of the carpal tunnel.  Additionally, the median nerve also slides through the tunnel; this nerve leads to a branch of motor muscles and sensory branches that enable more than 50% of the hand to experience sensory changes.  When the hand becomes stressed or weakened through repetitive use or trauma, the small space known as the carpal tunnel can start to collapse.  When that occurs several things can happen: the median nerve can sustain a great deal of damage, inflammation of the tendon can cause the tendon to swell, and the tunnel size decreases due to lack of support within the wrist joint itself.  Without sufficient space in the tunnel for the tendons and median nerve to slide through without obstruction, they become pinched or impinged and the result is carpal tunnel syndrome.
 Treatment and therapy can help.

Causes, Symptoms, and Potential Impact of Carpal Tunnel Syndrome

In recent years, perhaps as a response to the steadily increasing repetitive stress of – among other things — using computer keyboards, there has been an ongoing escalation in the number of Carpal Tunnel Syndrome cases reported. Because of the nerve entrapment that occurs in CTS, the symptoms can become both extremely painful and even debilitating.  In addition to the pain involved, people typically complain of the sensation of pins and needles and tingling in the hand. This can also result in numbness and a marked reduction in the thumb’s coordination function. Without proper treatment, the hand muscles can begin to show signs of atrophy and wasting away.  However, there are also other conditions that can cause CTS.  These include obesity, diabetes, and rheumatoid arthritis.  Smoking is also known to reduce the proper blood flow required by the median nerve.

Several studies indicate that the nationwide statistics for the development of Carpal Tunnel Syndrome have actually reached ‘epidemic levels’.  Moreover, if the issue is not adequately and effectively addressed, the U.S. could see CTS grow to ‘pandemic proportions’.  This, in turn, can have a negative impact on the work force across the nation.  Between lost days from work, inability to maintain productivity levels, the need for job retraining, and ultimately the cost of surgery or physical therapy to have CTS corrected, it is estimated that CTS could end up costing the U.S. some 100 billion dollars in the course of a year.

Treating Carpal Tunnel Syndrome
 in NYC

Once some other underlying medical condition has been ruled out as the cause of CTS, a range of different treatment approaches may be considered, depending on the nature of the pain and extent of the disability being caused by Carpal Tunnel Syndrome. Treatment and therapy can be an alternative to surgery. Not surprisingly, the sooner one begins treatment, the better the chances that the median nerve will not sustain serious or ongoing damage.

There are some basic things that people can do for themselves at home.  As soon as pain or tingling begins, discontinue the activity that is causing the symptom.  It is important to take rest breaks periodically in order to allow the wrist to return to normal.  The use of ice as well as an over-the-counter medication such as ibuprofen can help to ease swelling and reduce pain.  To help with hand and wrist pain, many people find it helpful to sleep with a wrist splint during the night.  The splint holds the wrist in a position that helps to reduce pressure on the median nerve.  If such conservative treatment does not show results after a week or so, or if symptoms are severe at the onset, it is likely that a pain management specialist or other physician will need to be consulted.

Although surgery for the condition is an option, this is usually considered to be a last resort. There are several Carpal Tunnel Syndrome treatment options available. In addition to conservative treatments such as icing and the use of a wrist splint, physicians may prescribe stronger anti-inflammatory drugs.  When anti-inflammatory medications taken orally are not sufficient to treat the problem, your physician might suggest the use of steroid injections such as prednisone placed directly into the carpal tunnel area of the wrist. When such measures are successful, the best follow-up is to protect the joint from future trauma and strain.

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