Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a common condition that results in pain, numbness, and tingling in the hand and arm. It is caused by increased pressure on the median nerve, which runs through the length of the arm, goes through a passage in the wrist called the carpal tunnel, and ends in the hand.

Symptoms

Carpal Tunnel Syndrome is characterised by the following symptoms:

  • Pain, numbness, and tingling in the fingers or hand, often affecting all fingers except the little finger.
  • Sensations of weakness or clumsiness in the hand, making it difficult to perform fine movements such as buttoning your clothes.
  • Pain or tingling that may travel up the forearm toward the shoulder.

Diagnosis

Diagnosis of Carpal Tunnel Syndrome can involve:

  • Physical examination: This includes testing for tenderness, swelling, and discolouration in the hand and wrist, and assessing the feeling and strength of your hands and fingers.
  • Electrodiagnostic tests: Tests such as nerve conduction study and electromyography can help measure the tiny electrical discharges produced in muscles to identify muscle damage and nerve dysfunction.
  • Ultrasound imaging: This can visualise the median nerve and detect possible abnormalities.

Prevention

To prevent Carpal Tunnel Syndrome:

  • Keep your hands warm: You’re more likely to develop hand pain and stiffness if you work in a cold environment.
  • Take frequent breaks: Give your hands and wrists a break by gently stretching and bending them periodically.
  • Improve your posture: Incorrect posture can cause your shoulders to roll forward, shortening your neck and shoulder muscles and compressing nerves in your neck, affecting your wrists, hands, and fingers.

Treatment

Treatment options for CTS include:

  • Splinting or brace: A splint or brace worn at night keeps the wrist in a neutral position, reducing pressure on the median nerve.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter drugs such as ibuprofen can relieve pain and inflammation.
  • Corticosteroids: These can be taken orally or injected into the carpal tunnel to reduce inflammation and swelling.
  • Surgery: In severe cases, surgery may be recommended to make more room for the median nerve in the carpal tunnel. The ligament over the carpal tunnel is cut, reducing pressure on the median nerve.