Carpal Tunnel Syndrome (CTS)

 

Image Source: Total Orthocare

Carpal tunnel syndrome, also called median nerve compression, is a condition that causes numbness, tingling, or weakness in your hand. It happens because of pressure on your median nerve, which runs the length of your arm, goes through a passage in your wrist called the carpal tunnel, and ends in your hand. The median controls the movement and feeling of your thumb and the movement of all your fingers except your pinky.

The symptoms of carpal tunnel syndrome include pain in your wrist, fingers, hand or arm, numb hands, a burning sensation in the middle and index fingers, tingling or pins and needles, an electric-like shock through the wrist and hand, a weak thumb or difficulty gripping. These symptoms are often exaggerated when the wrist is bent forward. The numbness or pain may be worse at night, and may actually keep you awake. During the day, it may occur more often when participating in activities that bend the wrist. You might first notice that your fingers "fall asleep" and become numb at night. It usually happens because of how you hold your hand while you sleep. In the morning, you may wake up with numbness and tingling in your hands that may run all the way to your shoulder. During the day, your symptoms might flare up while you’re holding something with your wrist bent, like when you’re driving or reading a book. Wrist anatomy, underlying health conditions and patterns of hand use can contribute to carpal tunnel syndrome.

A number of factors have been associated with carpal tunnel syndrome. Although they may not directly cause carpal tunnel syndrome, they may increase the risk of irritation or damage to the median nerve. These include:

> Anatomic factors. A wrist fracture or dislocation, or arthritis that deforms the small bones in the wrist, can alter the space within the carpal tunnel and put pressure on the median nerve.

> People who have smaller carpal tunnels may be more likely to have carpal tunnel syndrome.

> Gender. Carpal tunnel syndrome is generally more common in women. This may be because the carpal tunnel area is relatively smaller in women than in men. Women who have carpal tunnel syndrome may also have smaller carpal tunnels than women who don't have the condition.

> Nerve-damaging conditions. Some chronic illnesses, such as diabetes, increase your risk of nerve damage, including damage to your median nerve.

> Inflammatory conditions. Rheumatoid arthritis and other conditions that have an inflammatory component can affect the lining around the tendons in your wrist and put pressure on your median nerve.

> Medications. Some studies have shown a link between carpal tunnel syndrome and the use of anastrozole (Arimidex), a drug used to treat breast cancer.

> Obesity. Being obese is a risk factor for carpal tunnel syndrome.

> Body fluid changes. Fluid retention may increase the pressure within your carpal tunnel, irritating the median nerve. This is common during pregnancy and menopause. Carpal tunnel syndrome associated with pregnancy generally gets better on its own after pregnancy.

> Other medical conditions. Certain conditions, such as menopause, thyroid disorders, kidney failure and lymphedema, may increase your chances of carpal tunnel syndrome.

> Workplace factors. Working with vibrating tools or on an assembly line that requires prolonged or repetitive flexing of the wrist may create harmful pressure on the median nerve or worsen existing nerve damage, especially if the work is done in a cold environment.

However, the scientific evidence is conflicting and these factors haven't been established as direct causes of carpal tunnel syndrome. Several studies have evaluated whether there is an association between computer use and carpal tunnel syndrome. Some evidence suggests that it is mouse use, and not the use of a keyboard, that may be the problem. However, there has not been enough quality and consistent evidence to support extensive computer use as a risk factor for carpal tunnel syndrome, although it may cause a different form of hand pain.

There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on your hands and wrists with these methods:

> Reduce your force and relax your grip. If your work involves a cash register or keyboard, for instance, hit the keys softly. 

> For prolonged handwriting, use a big pen with an oversized, soft grip adapter and free-flowing ink.

> Take short, frequent breaks. Gently stretch and bend hands and wrists periodically. Alternate tasks when possible. This is especially important if you use equipment that vibrates or that requires you to exert a great amount of force. Even a few minutes each hour can make a difference.

> Watch your form. Avoid bending your wrist all the way up or down. A relaxed middle position is best. Keep your keyboard at elbow height or slightly lower.

> Improve your posture. Incorrect posture rolls shoulders forward, shortening your neck and shoulder muscles and compressing nerves in your neck. This can affect your wrists, fingers and hands, and can cause neck pain.

> Change your computer mouse. Make sure that your computer mouse is comfortable and doesn't strain your wrist.

> Keep your hands warm. You're more likely to develop hand pain and stiffness if you work in a cold environment. If you can't control the temperature at work, put on fingerless gloves that keep your hands and wrists warm.