Carpal Tunnel Syndrome: What is it, Causes, Symptoms and Treatment
The carpal tunnel is a canal structure in the wrist surrounded by bone and various other connective tissue elements. The median nerve, which has functions related to movement and sensation of the hand, passes through this canal.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a neuropathic disease that results in the median nerve passing through this canal being put under pressure for various reasons. The median nerve is responsible for the perception of sensation in the fingers other than the half of the ring finger and the little finger. Another feature of this nerve is that it takes part in motor functions by carrying electrical impulses to the muscles responsible for the movement of the thumb.
What Causes Carpal Tunnel Syndrome?
Carpal tunnel syndrome occurs as a result of pressure on the median nerve in the wrist area due to various diseases and anatomical changes. This pressure on the nerve may generally be caused by edema in the connective tissue of that area and interruption of blood flow.
Genetic predisposition, repetitive movements involving the wrist, obesity, rheumatic diseases and pregnancy are among the important risk factors for increased pressure in the canal. Carpal tunnel syndrome is a disorder that is more common in women than in men.
There are many diseases that are considered to be associated with the development of carpal tunnel syndrome during its course:
- Diabetes
- Thyroid gland diseases
- Excessive fluid retention in the body (fluid retention) seen during pregnancy and menopause
- Hypertension (high blood pressure)
- Autoimmune diseases in which the immune system causes damage to the body’s own cells and tissues.
- Traumas occurring in the wrist area.
Carpal tunnel syndrome usually does not occur due to a single cause. It is a picture formed by the combination of health problems and risk factors that may cause the development of this syndrome. The underlying reason why this disorder occurs more frequently in women than in men may be due to the fact that this gap follows a narrower course in women than in men.
Various health problems, such as diabetes, can cause damage to nerve structures in the body. In diseases such as rheumatoid arthritis, carpal tunnel syndrome may occur due to the development of an inflammatory process in the connective tissue in this area.
Use of heavy equipment is another risk factor that may result in the development of carpal tunnel syndrome. Carpal tunnel syndrome may occur in these people as a result of frequent exposure of the wrist to intense vibration over a long period of time. Long-term keyboard and mouse use, which has become a part of business life other than work machines, may also be among the causes of carpal tunnel syndrome.
What are the symptoms of Carpal Tunnel Syndrome?
The symptoms occurring in carpal tunnel syndrome are related to the normal functions of the median nerve, which is affected in this disorder. As a result of the damage to this nerve, which undertakes functions related to the sensation and movement of a part of the hand, a number of signs and symptoms occur in the person:
- Numbness, tingling and pain involving the thumb, index finger and middle finger
- Pain and feeling of warmth starting from the wrist and radiating to the arm
- Wrist pain that wakes you up at night
- Feeling of weakness in hand muscles
Symptoms that occur in carpal tunnel syndrome generally tend to develop slowly over time. An important finding is that the numbness and tingling complaint does not affect the little finger. The feeling of numbness in other fingers may also be accompanied by an occasional electric sensation.
Some people, after waking up at night due to wrist pain, instinctively feel the need to shake their wrist and express that they feel relieved after these movements, should be careful as this may indicate the presence of carpal tunnel syndrome in these people.
Feeling of weakness is a symptom that may occur in people with carpal tunnel syndrome. Patients may sometimes drop the objects they hold in their hands due to muscle weakness. Apart from weakness, twitching is another muscle-related symptom that may occur in carpal tunnel syndrome.
How to Diagnose Carpal Tunnel Syndrome?
As in all diseases, carpal tunnel syndrome can be diagnosed by using the patient’s history, physical examination and various diagnostic methods. Risk factors such as health conditions and working conditions that may cause the development of this syndrome in patients are important points that should be questioned when taking the patient’s history.
During the physical examination performed by the physician, various tests performed with certain movements may be used that may shed light on the presence of carpal tunnel syndrome. In the Tinel test, the patient’s carpal tunnel area is struck with the help of a reflex hammer. After the application of this test, the triggering of complaints that may occur in the person due to the impact of the median nerve allows the test result to be interpreted as positive.
Phalene test is another important test performed during the physical examination to diagnose carpal tunnel. In this test, the patient is asked to bring the outer parts of his hands together in front of his body and hold this position for 1 minute. The test result is considered positive if neuropathic symptoms such as numbness, tingling or pain occur in the patient during the test.
The basis of the diagnosis of carpal tunnel syndrome is the diagnostic procedure called electromyography (EMG). EMG allows examination of the muscles in the area where it is applied and the nerves responsible for stimulating these muscles. Electrical signals transmitted from the nerves to stimulate the muscles are detected by the EMG device and documented numerically so that they can be interpreted by physicians.
How is Carpal Tunnel Syndrome Treated?
Treatment of carpal tunnel syndrome may vary depending on the condition of the disease and the degree of complaints it causes in the person.
Carpal tunnel syndrome is a condition that can only be controlled with supportive treatment and various recommendations if it is detected in the early stages of the disease. Among the suggestions; These include informing the patient about wrist movements that may cause complaints and avoiding movements that force this area.
Medical products called wrist splints allow patients to keep their wrists in a normal position. The splint is especially useful in preventing the person from increasing the pressure on the wrist with involuntary movements at night.
When deemed necessary by physicians, various painkillers and anti-inflammatory drugs may be prescribed to control the edema in the wrist area and the person’s pain complaint. In some people, steroid injections in the carpal tunnel area to relieve inflammation may be included in the treatment plan.
In advanced cases, surgical interventions may be used to treat carpal tunnel syndrome. In this surgery, structures that put pressure on the median nerve in the person’s wrist area are identified and those structures are intervened to relieve the nerve.
In addition to carpal tunnel treatment, various methods applied with the knowledge and recommendation of physicians can have a positive effect on complaints arising from this disease:
- Carpal tunnel syndrome exercises
Repeating the movement 5-10 times, which is performed by opening the fingers of the hand formed into a fist so that they are parallel to the ground, is an exercise that can provide short-term relief from the pressure in the wrist area.
Apart from this movement, another carpal tunnel exercise that may be beneficial is to bring your hands in front of the body and shake them for 1 minute, approximately every 2 hours.
- Carpal tunnel syndrome bracelet use
Bracelets, which relieve the pressure on the median nerve by keeping the wrist in a straight position, are products that can be beneficial both in avoiding movements that increase complaints during the day and in avoiding involuntary challenging wrist movements at night.
