WHAT IS CARPAL TUNNEL SYNDROME?
Carpal tunnel syndrome (CTS) is a common problem affecting the hand and wrist. Symptoms begin when the median nerve gets squeezed inside the carpal tunnel of the wrist, a medical condition known as nerve entrapment. Any condition that decreases the size of the carpal tunnel or enlarges the tissues inside the tunnel can produce the symptoms of CTS.
WHAT CAUSES CARPAL TUNNEL SYNDROME?
Anything that increases the volume of the structures passing through the carpal tunnel will cause pressure against the median nerve. Many causes have been linked to the development of CTS, such as tasks that require rapid repetitive use of the hands, the use of vibrating tools, or prolonged power grip. Bone dislocations, fractures and arthritis can also cause narrowing of the tunnel, but they are usually not as common. Other conditions such as hypothyroidism, rheumatoid arthritis and diabetes can increase the likelihood of developing carpal tunnel syndrome. Fluid retention during pregnancy can sometimes cause swelling in the tunnel and produce symptoms of carpal tunnel syndrome, which are usually reversible after the pregnancy is over.
WHAT ARE THE SYMPTOMS OF CTS?
One of the first symptoms of CTS is gradual tingling and numbness in the areas supplied by the median nerve. This is typically followed by dull, vague pain where the nerve gives sensation in the hand. The hand may begin to feel like it’s asleep, especially in the early morning hours after a night’s rest.
HOW IS CARPAL TUNNEL SYNDROME DIAGNOSED?
An accurate medical history and detailed clinical examination will establish the diagnosis in most cases. A nerve test, called a nerve conduction study and electromyography is often obtained to confirm the diagnosis.
HOW IS CARPAL TUNNEL SYNDROME TREATED?
* Changing activities to reduce repetitive or strenuous use of the hand or keeping the wrist in a straight position may help reduce the swelling within the tunnel, allowing more room for the nerve.
* Wearing wrist splints at night may relieve the symptoms that interfere with sleep.
* A local injection of steroids into the carpal tunnel may provide help by reducing the swelling within the carpal tunnel.
* If conservative treatment is not successful in treating the carpal tunnel syndrome, then surgical treatment would be the treatment of choice.
* The main purpose of the surgery is to divide the transverse carpal ligament and therefore open the carpal canal and increase the volume of the carpal tunnel, and therefore relieve the pressure from the median nerve.
* Surgery is performed under a block anesthesia, which is essentially a local anesthesia on same-day surgery basis.
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