What is Carpal Tunnel Syndrome?

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is pressure on the median nerve. The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel.  The median nerve controls movement and feeling in your thumb and the first three fingers of the hand.  It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.

Carpal tunnel syndrome is becoming more frequently recognized and may be occurring more often.  It may result from repetitive motion or the use of devices like computer keyboards.  It affects the median nerve, the nerve that supplies feeling and movement to the thumb and “thumb-side” of the hand.

Symptoms

• Numbness or tingling in the thumb and next two or three fingers of one or both hands.
• Numbness or tingling of the palm.
• Pain extending to the elbow.
• Pain in the wrist or hand in one or both hands
• Problems with fine finger movements (coordination) in one or both hands
• Wasting away of the muscle under the thumb (in advanced or long-term cases)
• Weak grip or difficulty carrying bags (a common complaint)
• Weakness in one or both hands

Causes

For most patients, the cause of their carpal tunnel syndrome is unknown.  Any condition that exerts pressure on the median nerve at the wrist can cause carpal tunnel syndrome.  The carpal tunnel is normally narrow, so any swelling can pinch the nerve and cause pain, numbness, tingling, or weakness.  This is called carpal tunnel syndrome.

Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist.  Typing on a keyboard is probably the most common cause of carpal tunnel syndrome.  Other causes include:

• Sewing
• Driving
• Assembly line work
• Painting
• Writing
• Use of tools (especially hand tools or tools that vibrate)
• Sports such as racquetball or handball
• Playing some musical instruments

The condition occurs most often in people 30 to 60 years old and is more common in women than men.

Some medical problems associated with carpal tunnel syndrome include:

• Bone fractures and arthritis of the wrist
• Acromegaly
• Diabetes
• Alcoholism
• High blood pressure
• Hypothyroidism
• Kidney failure and dialysis
• Menopause, premenstrual syndrome (PMS), and pregnancy
• Infections
• Obesity
• Rheumatoid arthritis, systemic lupus erythematosus (SLE), and scleroderma

Treatment

You may try wearing a splint at night for several weeks.  If this does not help, you may need to try wearing the splint during the day.  Avoid sleeping on your wrists.  Hot and cold compresses may also be recommended.

There are many changes you can make in the workplace to reduce the stress on your wrist:

• Special devices include keyboards, different types of mouses, cushioned mouse pads, and keyboard drawers.
• Someone should review the position you are in when performing your work activities. For example, make sure the keyboard is low enough so that your wrists aren’t bent upward while typing.  Your doctor may suggest an occupational therapist.
• You may also need to make changes in your work duties or recreational activities. Some of the jobs associated with carpal tunnel syndrome include those that involve typing and vibrating tools.  Carpal tunnel syndrome has also been linked to professional musicians.

Conservative rehabilitation treatments such as chiropractic care and physiotherapy have been known to improve symptoms greatly while simultaneously removing the activities that irritate the median nerve. Regenerative medicine treatments such as PRP may also cause a natural decrease in inflammation as you undergo chiropractic care and rehabilitation.

Prevention

Avoid or reduce the number of repetitive wrist movements whenever possible.  Use tools and equipment that are properly designed to reduce the risk of wrist injury.

Ergonomic aids, such as split keyboards, keyboard trays, typing pads, and wrist braces, may be used to improve wrist posture during typing.  Take frequent breaks when typing and always stop if there is tingling or pain.

Summary

By learning more about carpal tunnel syndrome, we can better understand how to prevent and treat symptoms associated with it.  When carpal tunnel syndrome is present, whatever is required depends on the area affected and the symptoms present, and that is why it is important to have a team of doctors who can identify the root cause. 

At BBC Health in Lewisville, Texas, we know how to identify, treat, or refer in the proper direction for any problems with your hands.  As a primary care provider, we can quickly provide medical, chiropractic, and rehab treatments to get you well as fast as possible.  If you’re suffering from hand pain, don’t delay, and contact us immediately to see how we can help.

Author

Dr. Matthew Gilbert