Carpal tunnel syndrome is a nerve-related condition that affects three times as many women as men, according to the National Institute of Neurological Disorders and Stroke. It's primarily seen in adults, especially those who perform assembly line-type work. People who type for long periods of time are not at an increased risk of developing the disorder.
Picture the hand with the palm facing upward. The carpal tunnel is located in the wrist, and made of bones along the bottom and sides, and strong ligaments on top. Through this tunnel of bone and tissue, nerves from the arm travel into the hand, giving feeling to the palm side of the fingers (except the pinkie finger). The nerves — along with tendons — also aid movement.
Because the tunnel is narrow, swelling and irritation in joints and ligaments can put pressure on nearby nerves, and this causes the pain associated with carpal tunnel syndrome.
Individuals may initially experience aching, tingling and numbness in the wrist. These sensations may appear when the individual is holding an object, such as a book. As the condition worsens, pain may extend beyond the wrist all the way up to the shoulder, or into the hand.
Another common symptom is weakness. For example, individuals may notice that they drop objects more frequently.
There are many causes of carpal tunnel syndrome, including overuse of the wrist and hand. Carpal tunnel syndrome may also be secondary to other diseases such as diabetes and arthritis.
The most important risk factor is family history. A smaller-sized carpal tunnel is an inherited trait, and this increases the likelihood that the nerves may become compressed.
Diagnosis & Tests
A physician will first perform a physical exam. After examining feeling and strength in the hand, the doctor may also want to perform additional tests to rule out any other conditions.
An electromyogram checks for muscle damage by measuring the electrical output of muscles. The doctor places a tiny needle into particular muscles and tests them at rest and during movement.
A nerve conduction study tests the nerve, as opposed to the muscles, in the wrist. Two electrodes are placed on the surface of the skin, and a shock is sent to the nerve. If the shock travels more slowly through the carpal tunnel, that can confirm the presence of carpal tunnel syndrome.
Treatments & Medications
For mild cases of carpal tunnel syndrome, surgery is usually not necessary. Splinting the wrist (make sure it's secure but not too tight) while sleeping can provide relief during the night. Over-the-counter medications, such as nonsteroidal anti-inflammatory drugs, can alleviate pain related to inflammation.
Physicians may also administer corticosteroid shots into the carpal tunnel for pain relief.
If carpal tunnel syndrome is caused by an underlying condition, treatment of that condition is often effective in reducing carpal tunnel symptoms.
If pain persists for more than six months, surgery may be necessary. There are several different procedures a surgeon may use, but they typically involve reducing the pressure on the nerve.
Although alternative therapies will not cure carpal tunnel syndrome, they can offer temporary pain relief. Taking breaks from activities that strain the wrist may help control swelling. Yoga can strengthen and stretch muscles and joints to reduce pain.
Other techniques, such as acupuncture and ultrasound treatments, have not been proven effective in clinical trials to date.
There are several ways to reduce the risk of developing carpal tunnel syndrome. One of the easiest ways is to take breaks from activities that strain the wrist, and bend the wrist every so often.
Individuals who type as part of their profession should keep the keyboard at elbow height or lower so the wrist is relaxed during work. Posture is extremely important. Keep the shoulders back to avoid straining neck and shoulder muscles, which can eventually cause problems in the wrists and hands.
Use the appropriate force when performing tasks such as writing or typing. In other words, don't grip the pen tightly or bang the keys on the keyboard.. This puts unnecessary stress on the wrist and hand.
Finally, try to keep hands warm. Cold environments can cause stiffness and pain.