Carpal Tunnel Syndrome

Carpal tunnel syndrome is a medical condition caused by compression of the median nerve in the wrist. This compression occurs when tissues surrounding the flexor tendons become swollen. The carpal tunnel is a fairly narrow passageway located on the palm side of the wrist, and when squeezed can cause various symptoms.

Symptoms

Symptoms generally start gradually with an aching in the wrist. Later, symptoms of numbness or tingling to the fingers, particularly the thumb, index and middle finger occur. Weakened grip and dropping of objects may occur as well. Severe cases may even cause muscles at the base of the thumb to waste away.

Causes

There is a combination of factors that result in carpal tunnel syndrome. Women are three times more likely to develop it, likely because the tunnel itself is narrower in women. Chronic conditions such as diabetes, hypothyroidism, arthritis and alcoholism increase risk of development. Carpal tunnel syndrome is also associated with obesity, pregnancy and menopause. Of course, workplace factors such as working with vibrating tools or repetitive flexing of the wrist may play a role. Perhaps surprising, there is no evidence to support use of a keyboard with the development of carpal tunnel syndrome.

Diagnosis

To diagnose carpal tunnel syndrome, a physician visit is required. Tests such as tapping on the wrist or holding flexion on the wrist may produce symptoms that indicate possible carpal tunnel syndrome. Physicians may also order an EMG or nerve conduction study to confirm diagnosis.

Treatment

Wrist splinting at night or at work to keep the wrists from flexing can be helpful. Ergonomic changes evaluated by an occupational or physical therapist at work can also lead to improvement. There are also medications that can decrease pain and inflammation.

If symptoms persist, an orthopedic referral is needed. Options may include steroid injection or surgery. Fortunately, most cases resolve without surgical intervention.

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