| General
Illness Information |
Common Name: |
Carpal
Tunnel Syndrome |
|
Medical
Term:
|
None
Specified |
| Description: |
Common
painful disorder in the hand and wrist, caused by compression
(pressure) on the median nerve at the wrist.
|
| Causes: |
May be caused by: Inflammation
of the tendon sheaths; Frequently from arthritis; A fracture of
the forearm; Sprain or dislocation of the
wrist; Ganglion cyst; Hyperparathyroidism and
hypocalcemia
Most
often associated with hypothyroidism and diabetes. Occurs with increased frequency in
pregnancy.
May be caused by other
conditions such as acromegaly, lupus, leukemia, sarcoidosis,
primary amyloidosis and paget’s disease.
|
| Prevention: |
Take a break at least once an hour when doing
repetitive work involving hands.
Wear a wrist brace or support if your work
involves doing repetitive work involving hands.
|
| Signs
& Symptoms |
 |
Tingling and/or numbness in affected hands-
affects the first three fingers i.e. the thumb, index and
middle finger.
|
|
Shaking
or rubbing the hands characteristically relieves symptoms. |
|
Burning
sensation in same area. |
|
Aching pain extending from wrist, and may cause
pain in forearm, shoulder, neck and chest.
|
|
Pain may be worsened by manual activity.
|
|
Pain
may be worse at night.
|
|
Thumb
weakness and atrophy of the muscles on the thumb side of the
hand
|
|
Weakness
of the hand may be the first symptom, wherein the patient
has difficulty opening jars.
|
|
| Risk
Factors |
|
Hypothyroidism.
|
|
Work that requires repetitive hand or wrist
action e.g. computer operator, seamstress |
|
Pregnancy.
|
|
Rheumatoid
arthritis and gout.
|
|
Diabetes
mellitus.
|
|
Menopause.
|
|
Raynaud's disease.
|
|
Ganglion
cyst.
|
|
| Diagnosis
& Treatment |
| General
Measures: |
|
Diagnostic
studies may include blood test, electrophysiologic nerve
tests (EMG) (records electrical activity of the muscles) and
X-rays of the hand and wrist.
|
|
Conservative
treatment is usually tried first- using wrist splints.
|
|
Shaking
hands or dangling arms may relieve discomfort.
|
|
Wearing
a splint on the affected wrist at night may be recommended.
If symptoms are worse in the daytime then working wrist
splints are recommended, to prevent over-extension of the
wrist.
|
|
For
work at a computer terminal, be sure desk, keyboard and
chair are at the proper height. Take a break once an hour.
|
|
Surgery to free the pinched nerve. Provides
almost complete relief from all symptoms in over 90% of
patients.
|
|
Procedure
is usually done as an outpatient. Allow 2 to 3 weeks for
healing and 2 weeks for recuperation before the hand can be
fully utilized for tasks requiring strength.
|
|
For
patient education material contact: American Academy of
Family Physicians Foundation, P.O. Box 8418, Kansas City, MO
64114,(800)274-2237.ext.4400.
|
|
| Medications: |
|
Anti-inflammatory
drugs to reduce inflammation.
|
|
Cortisone
injections at the wrist to reduce inflammation.
|
|
Thyroid
medication in case of hypothyroidism
|
|
| Activity: |
|
Stay
as active as your strength allows. If surgery has been
necessary, allow time for recovery. Exercises may be
prescribed for the hand.
|
|
| Diet: |
|
Eat
a normal, well-balanced diet.
|
|
| Possible
Complications : |
|
Permanent
numbness and a weak thumb or fingers in the affected hand.
|
|
Permanent
paralysis of some of the hand and finger muscles.
|
|
| Prognosis |
|
Usually curable, sometimes spontaneously,
sometimes with surgery. Surgery usually needed if muscle
wasting or nerve changes have developed.
|
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| Other |
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