Carpal Tunnel Syndrome

More than eight million people are affected by carpal tunnel syndrome annually. While many people attribute the cause to long days at a keyboard, its origins are generally more difficult to define.

The carpal tunnel is a narrow area composed of bones and ligaments on the side of your palm. Carpal tunnel syndrome is caused by pressure on the median nerve in that area, which can present as numbness, tingling and weakness in the hand and arm.

Risk Factors

Just as some people are smaller than others, some are also born with smaller carpal tunnels. These individuals are at higher risk for developing carpal tunnel syndrome because the median nerve has less room inside the tunnel and is more likely to be compressed. Other risk factors include:

• A cyst growing in the tunnel
• Changes in blood sugar levels (like Type 2 diabetes)
• Family history of carpal tunnel syndrome
• Fluid retention or hormonal imbalance during pregnancy or menopause
• Frequent, repetitive movements such as typing
• Frequent, repetitive, grasping movements in sports
• Hypothyroidism
• Joint or bone disease (like arthritis)
• Trauma or injury that causes swelling

Symptoms

Carpal tunnel syndrome is marked by the gradual appearance of symptoms, including burning, numbness or an electric shock-like sensation that travels up the arm that begins in the hand and fingers. Because people often sleep with their wrists flexed, symptoms can often be more severe at night, but symptoms can occur at any time. If you do not seek treatment, the pain may become constant.

Treatment

Treatment for carpal tunnel syndrome begins with pinpointing the cause of your symptoms. Through X-rays and electrophysiological and manual exams that test the median nerve's function, your doctor will be able to target the problem. Once the cause is determined, your doctor might advise:

• Activity modification and anti-inflammatory medications, such as ibuprofen or corticosteroid injections, can give relief for a time, but symptoms may return.
• Bracing or splinting during repetitive motions and while you sleep can keep your wrist in a neutral position and prevent wrist movement from contributing to compression of the median nerve.
• Minimally invasive surgical interventions can successfully reduce pressure on the median nerve by dividing the carpal ligament and increasing the size of the carpal tunnel.

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