Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is caused by pressure on the median nerve. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of your hand. When the median nerve is compressed, the symptoms can include numbness, tingling, and weakness in the hand and arm. The anatomy of your wrist, health problems, and possibly repetitive hand motions can contribute to carpal tunnel syndrome. Proper treatment usually relieves the tingling and numbness and restores wrist and hand function.

Symptoms

Symptoms usually start gradually and may include: • Tingling or numbness in fingers, especially thumb, index, and middle fingers • Pain in the hand or arm • Shock-like sensations that radiate to fingers • Weakness and tendency to drop objects • Symptoms that often occur while holding items • Symptoms that may travel from wrist up the arm • Symptoms often worse at night • Shaking hands to relieve numbness

Diagnosis

Diagnosis may involve: • Medical history of symptoms and activities • Physical examination including Tinel's sign and Phalen's maneuver • X-rays to check for other causes like arthritis • Electromyogram (EMG) to measure electrical activity of muscles • Nerve conduction study to test signals traveling in nerves • Ultrasound to examine the median nerve

Treatment

Treatment options include: • Wrist splinting, especially at night • NSAIDs to reduce pain and inflammation • Corticosteroid injections to reduce inflammation • Activity modification and ergonomic adjustments • Hand exercises and physical therapy • Treating underlying conditions • Surgery (carpal tunnel release) if conservative treatments don't help • Endoscopic or open surgery options available

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