Carpal Tunnel Syndrome

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.

Other

Nothing specified.