What Are Carpal Tunnel Syndrome Symptoms?
Numbness, pain and tingling in your hand and forearm may be an indication that you have carpal tunnel syndrome. The median nerve, the major nerve that supplies the hand, can become compressed in the carpal tunnel of the wrist, leading to carpal tunnel syndrome symptoms that can affect your ability to perform normal, everyday activities.
Carpal Tunnel Syndrome Explained
The carpal tunnel is a narrow tunnel, which is surrounded by small bones and connective tissue that is found on the palm side of each wrist. The median nerve originates in the neck and passes through the carpal tunnel to supply feeling to the thumb, index, middle and ring fingers. The median nerve is also responsible for carrying impulses to the muscles of the thumb.
The condition results when the connective tissues and muscles around the median nerve become irritated or inflamed. This results in a narrowing of the carpal tunnel and compression of the median nerve, leading to potentially painful symptoms.
What Are the Risk Factors?
Various risk factors have been identified which increase the risk of developing this syndrome:
- Wrist positioning. Prolonged periods of the wrist being in a strained position, either flexed or extended, can lead to irritation and inflammation of the wrist.
- Menopause or pregnancy. Hormonal imbalance can lead to swelling of the wrists.
- Certain diseases. Diseases such as rheumatoid arthritis, diabetes, obesity and hypothyroidism can increase the risk of carpal tunnel syndrome.
- Genetic factors. Anatomical differences, including a narrowed carpal tunnel, can be found in certain individuals, increasing the risk of carpal tunnel syndrome.
- Previous wrist injury. A fracture or dislocation increases the risk of carpal tunnel syndrome.
Carpal Tunnel Syndrome Symptoms
Symptoms may look like:
- Pain, numbness and/or tingling of the thumb, index, middle and ring finger
- Tingling that radiates up the arm
- Weakness of the muscles in the affected hand
- Difficulty holding things in the affected hand
- Dropping objects frequently
Symptoms of carpal tunnel often start off mild and worsen gradually overtime. Additionally, carpal tunnel syndrome symptoms may be worse at night, which is often due to individuals sleeping in positions that bend the wrists, which further compresses the median nerve. Furthermore, symptoms may be aggravated during the day when the wrist is positioned in a flexed position (i.e. typing on a keyboard) for an extended period of time.
The Diagnostic Process
Your doctor will take a detailed history of your symptoms and perform a physical exam of the area that may include various orthopedic tests including Tinel’s tap and the wrist-flexion test. Additionally, they may order further testing including imaging such as an x-ray, ultrasound, or MRI to evaluate the bones and tissues of the affected area, electromyogram to evaluate the electrical activity in the area and nerve conduction studies to measure the nerve signaling in the arm and hand.
Preventing Carpal Tunnel Syndrome
There are various things you can do to minimize your risk of developing this syndrome:
- Maintain a neutral wrist position
- Maintain a relaxed wrist position when gripping objects
- Take breaks throughout the day to stretch your wrists and minimize pressure on the median nerve
- Ensure your workstation is ergonomically friendly to reduce stress on your wrists
- Keep your hands warm
There are conservative, non-surgical and surgical options for treating this condition. Often, your doctor will recommend trying non-surgical options if your symptoms are mild to moderate.
Non-surgical Treatment Options
One of the first non-surgical treatment options is splinting or bracing. This is wearing a splint, especially while you sleep. It can help to keep your wrist in a neutral position and takes pressure off the median nerve.
Non-steroidal Anti-inflammatory Drugs
Non-steroidal anti-inflammatory drugs (NSAIDs) are medications, including ibuprofen and naproxen, that may be recommended to decrease pain and inflammation.
Icing the affected area means applying ice for 10 to 15 minutes at a time. This can help to decrease pain and inflammation.
Stretch and Strengthen
Stretching and strengthening exercises that are specific to carpal tunnel can be performed to help encourage movement of the median nerve in the carpal tunnel.
Surgical Treatment Options
Surgical treatment options are typically reserved for patients with severe symptoms and for those who have not responded to conservative treatment options. Surgical treatment involves cutting the ligament that forms the roof of the carpal tunnel to widen the tunnel area and reduce pressure on the median nerve and give it more room to move freely, thereby reducing symptoms of carpal tunnel syndrome.
Carpal tunnel syndrome symptoms can cause numbness, tingling, pain and weakness in your hand and arm. This can make performing normal activities quite difficult. It’s important to speak to your doctor at the first sign of carpal tunnel syndrome, as early treatment can help to avoid persistent or progressive symptoms.