Recently, one of my friends, whose job entailed long hours on the computer, complained of a tingling sensation followed by a numbness of the index, thumb and middle fingers. Sometimes she also experienced of a sharp shooting pain which traveled all the way up her wrist to her arm.
A visit to the doctor revealed that she was suffering from carpal tunnel syndrome. Women are more likely to suffer from carpal tunnel syndrome than men. A narrow passageway of bones and ligaments, situated at the base of the hand is called the carpal tunnel. This tunnel also contains tendons and nerves. An important nerve called the median nerve which receives sensations from the middle finger, index finger and thumb also passes through this tight space called the carpal tunnel.
Sometimes certain conditions can cause the tissues to swell or change position. The tendons inside the carpal tunnel can also get inflamed. This inflammation of the tissues or tendons inside the carpal tunnel puts undue pressure on the median nerve. When the median nerve is squeezed inside the carpal tunnel because of the pressure exerted on it by the inflamed tissues and tendons, it can cause numbness and a tingling sensation in the middle finger, index finger and the thumb. This condition is called the carpal tunnel syndrome.
The carpal tunnel syndrome gradually worsens with time. Initially the symptoms of carpal tunnel syndrome are so slight that most people are not even aware of it. However at its peak, carpal tunnel syndrome can cause excruciating pain which can hamper the normal functioning of one’s life. Many patients are unaware of the factors which can lead to carpal tunnel syndrome. Basically any condition wherein undue pressure is exerted on the median nerve can cause carpal tunnel syndrome. Let us now examine some of the common factors which trigger carpal tunnel syndrome in people.
Inflammation of the soft tissues and joints of the arms which may be caused by certain illnesses like diabetes, hypothyroidism, obesity, lupus or rheumatoid arthritis can cause carpal tunnel syndrome. These health conditions can also reduce the blood flow to the hands. Fractured wrists, dislocated bones, or bone spurs can exert pressure on the median nerve located inside the carpal tunnel and cause carpal tunnel syndrome. Repetitive hand and wrist movements can lead to the tendon sheaths or the protective membranes covering the tendons to become inflamed. This inflammation of the tendon sheaths can cause carpal tunnel syndrome as the swollen membranes start exerting pressure on the median nerve.
Certain types of growths like ganglions and even benign tumors on the wrist are trigger factors which cause carpal tunnel syndrome. During pregnancy or if a person is suffering from diabetes of rheumatoid arthritis, edema or fluid buildup occurs inside the carpal tunnel. This also results in carpal tunnel syndrome. With ageing and repetitive hand movements comes wear and tear of the wrist which can cause carpal tunnel syndrome. People who smoke excessively suffer from this condition as the blood flowing to the median nerve is restricted.
Working in uncomfortable positions, repetitive hand and wrist movements, using the hand and wrist very forcefully (like when playing tennis) can also cause carpal tunnel syndrome. Certain rare diseases like sarcoidosis, amyloidosis, leukemia and multiple myeloma can result in the deposition of anomalous substances in the region surrounding the carpal tunnel. This is another factor which causes carpal tunnel syndrome. While carpal tunnel syndrome commonly affects both hands, the symptoms associated with this condition are greater in one hand. Some of the typical symptoms of carpal tunnel are weakness, numbness, tingling sensation and pain in the fingers especially at night.
People with carpal tunnel syndrome have no difficulty in falling asleep. However as the pain associated with this condition worsens at night, most people suffering from carpal tunnel syndrome tend to wake up several times in the night. The reason why the pain linked to carpal tunnel syndrome increases at night could be due to two reasons. The first is fluid accumulation around the wrist and the second reason is that we tend to bend our wrist unconsciously while sleeping. The fingers which are typically affected by the carpal tunnel syndrome are the middle and index finger, half of the ring finger and the thumb. Normally the little finger is not affected by carpal tunnel syndrome.
Some of the very first symptoms of carpal tunnel syndrome are a sensation of pins and needles or a tingling sensation on the hand. Stiffness in the fingers and pain while grasping an object is also felt in this condition. As carpal tunnel syndrome progresses, the person may find difficulty in doing simple everyday activities like brushing the hair, or opening a can of fruits. The pinching ability or the ability to grasp objects between the thumb and index finger also decreases.
There are several techniques which have been designed to detect whether a person is suffering from carpal tunnel syndrome or not. A medical practitioner will ask detailed questions regarding the exact nature, intensity and location of the pain. The doctor may also conduct some physical examination on the patient including Phalen’s sign, Tinel’s sign and two point discrimination tests. Once a person has been diagnosed with carpal tunnel syndrome the doctor teaches the patient a range of motion stretching exercises which will help to reduce at least some of the pain. Non Steroidal Anti Inflammatory Drugs or NSAID and vitamin B6 are also prescribed to bring down the pain.
If the patient continues to suffer pain, the doctor will recommend that the person goes in for some detailed tests including nerve tests like electromyogram tests, ultrasound tests, x-rays, MRI scans and blood tests especially if the person is suffering from carpal tunnel syndrome as a result of some underlying health problem like rheumatoid arthritis or hypothyroidism. If a person is suffering from an advanced case of carpal tunnel syndrome then the patient is advised to go in for a minor surgery which will help to reduce the pressure exerted on the median nerve by removing the band of tissue which builds up around it. One can prevent carpal tunnel syndrome by avoiding repetitive hand and wrist motion, using correct posture, stopping activities which causes pain in the hand or wrist, wearing a wrist splint and also reducing the salt intake.