Southern Cross Medical Library
The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
How Can Carpal Tunnel Syndrome Be Prevented
Carpal tunnel syndrome can be difficult to prevent. The condition can be caused by so many different activities in a persons daily life that prevention can be challenging. Workstation changesproper seating, hand and wrist placementcan help decrease some factors that can lead to carpal tunnel syndrome. Other preventative methods include:
- Sleeping with your wrists held straight.
- Keeping your wrists straight when using tools.
- Avoiding flexing and extending your wrists repeatedly.
- Taking frequent rest breaks from repetitive activities.
- Performing conditioning and stretching exercises before and after activities.
- Monitoring and properly treating medical conditions linked to carpal tunnel syndrome.
How Does Carpal Tunnel Syndrome Develop
Bending the wrist or moving the fingers brings muscles and tendons into action. For example, when a person bends a finger, the tendon moves about two inches. The tendons of the hand are encased in sheaths, or sleeves through which the tendons slide. The inner wall of the sheaths contains cells that produce a slippery fluid to lubricate the tendons. Lubrication is essential for the normal and smooth functioning of the tendons. With repetitive or excessive movement of the hand, the lubrication system may malfunction. It may not produce enough fluid or it may produce a fluid with poor lubricating qualities. Failure of the lubricating system creates friction between the tendon and its sheath causing inflammation and swelling of the tendon area. In turn, the swelling squeezes the median nerve in the wrist or carpal tunnel. Repeated episodes of inflammation cause fibrous tissue to form. The fibrous tissue thickens the tendon sheath, and hinders tendon movement.
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How Do You Treat Severe Carpal Tunnel Syndrome
In most cases, even severe carpal tunnel syndrome can still be successfullytreated. Thebest remediesaim to relieve pressure on the median nerve. In most cases, relieving the surrounding fluid pressure can make the nerve plump up, and return to its normal self – or very close to it.
When treating severe carpal tunnel syndrome, doctors and patients consider 3 main factors.
- How intense the symptoms are
- The length of time youve had these symptoms
- The degree to which these symptoms affect your life
You shouldneverallow symptoms to advance so far that the numbness or pain is ruining your life. That’s when treatment is most challenging. But this unfortunate situation is what happens in many cases.
Remember, severe carpal tunnel syndrome can still be treated, it’s just more difficult to end up with good results. Ideally, you want tointervene in the mild stagein order to see good results.
What Causes Carpal Tunnel Syndrome
CTS happens when the carpal tunnel inside your wrist swells and squeezes 1 of your nerves .
You’re more at risk if you:
- are overweight
- are pregnant
- do work or hobbies that mean you repeatedly bend your wrist or grip hard, such as using vibrating tools
- have another illness, such as arthritis or diabetes
- have a parent, brother or sister with CTS
- have previously injured your wrist
Page last reviewed: 16 February 2021 Next review due: 16 February 2024
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How Often Is Hand Pain Caused By Carpal Tunnel Syndrome
While carpal tunnel syndrome is a common condition, it has a different set of symptoms from many other sources of hand pain. There are actually several similar conditions that cause hand pain. These include:
- De Quervains tendinosis: A condition where swelling affects the wrist and base of the thumb. In this condition, you will feel pain when you make a fist and simulate shaking someones hand.
- Trigger finger: This condition causes soreness at the base of the finger or thumb. Trigger finger also causes pain, locking and stiffness when bending the fingers and thumb.
- Arthritis: This is a general term for many conditions that cause stiffness and swelling in your joints. Arthritis can impact many joints in your body and ranges from causing small amounts of discomfort to breaking down the joint over time .
Diagnosis Of Carpal Tunnel Syndrome
Your GP will ask you about your symptoms and your medical history. Theyll want to know when you get symptoms, what triggers them, and how theyre affecting your daily life. Theyll carefully examine both your hands, looking for signs such as swelling or muscle wasting. Theyll also check the feelings in your fingers and thumb. They may carry out some brief tests to check your symptoms. These may include:
- asking you to bend your wrist with your palm towards your forearm
- tapping or pressing over your median nerve on the inside of your wrist
- pressing on the ligament over your carpal tunnel in your wrist
Your GP may be able to diagnose carpal tunnel syndrome just by examining you and asking about your symptoms. But sometimes they may ask you to have some further tests. These may include the following.
- Nerve conduction test this can show how bad any damage to your median nerve is.
- Ultrasound this allows your doctor to look inside your wrist, and can help to show if theres any underlying cause.
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What Is Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common condition that causes pain, numbness, tingling, and weakness in the hand and wrist. It happens when there is increased pressure within the wrist on a nerve called the median nerve. This nerve provides sensation to the thumb, index, and middle fingers, and to half of the ring finger. The small finger is typically not affected.
Carpal tunnel syndrome was first described in the mid-1800s. The first surgery for the release of the carpal tunnel was done in the 1930s. It is a condition that has been well recognized by orthopaedic surgeons for over 40 years.
Who Is At Risk For Carpal Tunnel Syndrome
People at risk for carpal tunnel syndrome are those who do activities or jobs that involve repetitive finger use. Motions that can place people at risk of developing carpal tunnel syndrome include:
- High-force .
- Extreme wrist motions.
Many other factors can also contribute to the development of carpal tunnel syndrome. These factors can include:
- Heredity .
- Amyloid deposits .
Carpal tunnel syndrome is also more common in women than in men.
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When Should You Call Your Doctor
911 or go to an emergency room immediately if you notice sudden loss of feeling in your arm.
- Have tingling, numbness, weakness, or pain in your fingers or hand that keeps coming back or that has not gone away after 2 weeks of home treatment.
- Have gradually developed little or no feeling in your fingers or hand.
- Cannot do simple hand movements, or you accidentally drop things.
- Cannot pinch your thumb and index finger together, or your pinch is weak.
- Cannot use your thumb normally .
- Have problems at work because of pain in your fingers or hand.
What Are The Early Signs
Typically, the symptoms start out slowly, with burning, numbness, tingling, or pain. You might feel it in your thumb and any of your fingers, but not your pinkie. The strange feeling may also travel up your forearm.
Often, symptoms start at night. Thatâs because most people sleep with their wrists bent, which causes pressure on the median nerve. You might wake up feeling like you need to shake your hands out.
As your condition gets worse, you may notice symptoms during the day, as well. This often happens when youâre doing something where your wrist is bent up or down for a long time, like driving a car, reading a newspaper, or holding your phone.
At first, symptoms tend to come and go. But over time, they occur more often and become worse.
You might also notice other symptoms:
- Your fingers feel swollen, even though they donât look like it.
- Pain and tingling travel up your forearm to your shoulder.
- âShocksâ come and go in your thumb and fingers.
Over time, carpal tunnel can also affect your grip and ability to pinch. Here are some things that could be happening:
- You drop things more often .
- Youâre having a hard time working with small objects, like the buttons on your shirt.
- Itâs harder to make a fist than it used to be.
In more severe cases, you can lose muscle at the base of your thumb. Or you may no longer be able to tell hot from cold just by touch.
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Talk To Your Doctor About Surgery
If conservative treatment options dont work, or if your symptoms are severe, you may need surgery. Surgery is usually done as a last resort.
During surgery, the doctor will cut the ligament thats putting pressure on the median nerve. This relieves the symptoms of carpal tunnel.
Recovery from surgery takes time, but most people see a significant improvement in their symptoms.
How Is It Treated
Mild symptoms usually can be treated with home care. You can:
- Stop activities that cause numbness and pain. Rest your wrist longer between activities.
- Ice your wrist for 10 to 15 minutes 1 or 2 times an hour.
- Try taking non-steroidal anti-inflammatory drugs to relieve pain and reduce swelling.
- Wear a wrist splint at night. This takes pressure off your median nerve.
The sooner you start treatment, the better your chances of stopping symptoms and preventing long-term damage to the nerve.
You also may need medicine for carpal tunnel syndrome or for a health problem that made you likely to get carpal tunnel syndrome.
Surgery is an option. But it’s usually used only when symptoms are so bad that you can’t work or do other things even after several weeks to months of other treatment.
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Symptoms And Signs Of Carpal Tunnel Syndrome
The earliest symptoms of CTS are usually tingling / pins and needles, in some combination of the thumb, index, middle and ring fingers which most characteristically wake the patient during the night, usually at about 3:00 am but a variety of other things may be noticed by the patient or medical professional examining the hand.
Who Is At Risk Of Developing Carpal Tunnel Syndrome
Women are three times more likely than men to develop carpal tunnel syndrome. People with diabetes or other metabolic disorders that directly affect the bodys nerves and make them more susceptible to compression are also at high risk. CTS usually occurs only in adults.
Workplace factors may contribute to existing pressure on or damage to the median nerve. The risk of developing CTS is not confined to people in a single industry or job, but may be more reported in those performing assembly line worksuch as manufacturing, sewing, finishing, cleaning, and meatpackingthan it is among data-entry personnel.
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What Are The Symptoms Of Carpal Tunnel Vs Arthritis
Carpal Tunnel Symptoms
The following are symptoms associated with carpal tunnel syndrome. You may still have carpal tunnel syndrome if you have only a few symptoms.
- Numbness, pain , and tingling in your thumb, index, and middle fingers
- Tingling, numbness, or pain, which may move up your arm to your elbow
- Hand weakness
- Dropping objects
- Difficulty feeling and handling small objects
Symptoms are usually worse at night and are sometimes temporarily relieved by “shaking out” your hands.
Symptoms of arthritis include limited function and pain in the joints.
- Inflammation of the joints from arthritis is characterized by joint stiffness, swelling, redness, and warmth.
- Tenderness of the inflamed joint can be present. Loss of range of motion and deformity can result.
- Certain forms of arthritis can also be associated with pain and inflammation of tendons surrounding joints.
- Arthritis can affect any joint in the body, including the knees, hips, fingers, wrists, ankles, feet, back, and neck. The pain may be intermittent or constant.
- Some types of arthritis cause acute episodes of symptoms .
Some forms of arthritis are more of an annoyance than a serious medical problem. However, millions of people suffer daily with pain and disability from arthritis or its complications.
Moreover, many of the forms of arthritis, because they are rheumatic diseases, can cause symptoms affecting various organs of the body that do not directly involve the joints.
How Do Doctors Treat Carpal Tunnel Syndrome
Treatment can include:
Avoiding positions that bend your wrist too much or put pressure on your wrist, like using a keyboard incorrectly
Wearing wrist splints to keep your wrists straight, especially while sleeping or when using a keyboard or hand tool
Taking mild pain relievers such as ibuprofen or acetaminophen
Getting shots into your wrist of medicine called corticosteroids, if the pain is severe
Having surgery, if your pain is severe or your muscle shrinks or weakens
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Treatment For Severe Symptoms
If symptoms persist for more than 6 months and are interfering with your daily life and work activities, despite self-care and treatment, you may need surgery. Surgery relieves pressure on the trapped nerve and aims to prevent any permanent nerve damage. Your doctor will be able to discuss the most suitable method of surgery with you.
How Is Carpal Tunnel Syndrome Diagnosed
First, your doctor will discuss your symptoms, medical history and examine you. Next, tests are performed, which may include:
- Tinels sign: In this test, the physician taps over the median nerve at the wrist to see if it produces a tingling sensation in the fingers.
- Wrist flexion test : In this test, the patient rests his or her elbows on a table and allows the wrist to fall forward freely. Individuals with carpal tunnel syndrome will experience numbness and tingling in the fingers within 60 seconds. The more quickly symptoms appear, the more severe the carpal tunnel syndrome.
- X-rays: X-rays of the wrist may be ordered if there is limited wrist motion, or evidence of arthritis or trauma.
- Electromyography and nerve conduction studies: These studies determine how well the median nerve itself is working and how well it controls muscle movement.
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What Are Carpal Tunnel Syndrome Medications And Treatment
Carpal tunnel syndrome is not primarily an inflammatory process. However, pain is a common complaint, and anti-inflammatory medications are sometimes used to try to treat the pain.
- Anti-inflammatory medications such as ibuprofen may provide some relief but are unlikely to cure carpal tunnel syndrome.
- Direct injection of steroid medication by your doctor into the carpal canal has been shown to be an effective treatment for some people with carpal tunnel syndrome. This is a procedure that can be done in the doctor’s office with only minimal discomfort.
Living With Carpal Tunnel Syndrome
You may decide against having surgery for your carpal tunnel syndrome. If so, here are some things that may help relieve your symptoms.
- Prop up your arm with pillows when you lie down.
- Avoid overusing the affected hand.
- Find a new way to use your hand by using a different tool.
- Try to use the unaffected hand more often.
- Avoid holding your wrists in a downward bent position for long periods of time.
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Surgery For Carpal Tunnel Syndrome
Surgery for carpal tunnel syndrome is usually done as an outpatient. Two types of carpal tunnel surgery are done: open surgery and endoscopic surgery. You may have local or general anesthesia, or both, for either surgery.
During open surgery, the surgeon cuts open your wrist. The tissue that is pressing on the nerves is cut. This relieves the pressure on the nerve.
During endoscopic surgery, the surgeon puts a long, thin rod through a tiny cut on the wrist. The rod, or scope, contains a camera and a light. The scope lets the surgeon to see inside your wrist. He or she cuts the tissue using tiny surgical tools.
After the surgery, your hand and wrist are wrapped and put into a splint. This will help to keep you from moving your wrist during your recovery. You will need to wear the splint for a week or two. You will probably have some pain after your surgery. It’s usually controlled with pain medication taken by mouth. You may also be told to sleep with your hand elevated to help ease swelling.
Recovery from carpal tunnel surgery is different for each person. If your nerve has been compressed for a long time, recovery may take longer. You will be encouraged to move your fingers and wrist a few days after surgery to help prevent stiffness.
You may need to adjust your work or home activities while you recover. Talk with your health care provider about what you need to change.
What Are The Causes Of Carpal Tunnel And Arthritis
Carpal Tunnel Causes
The following are risk factors associated with the development of carpal tunnel syndrome:’
Carpal tunnel syndrome is rare in children.The relationship between work and carpal tunnel syndrome is unclear. Positions of extreme wrist flexion and extension are known to increase pressures within the carpal canal and apply pressure on the nerve. This is particularly true with repetitive strain injury to the wrist. Intensity, frequency, and duration of work activity and their relationship to carpal tunnel syndrome are unclear.
- injury ,
- abnormal metabolism ,
- inheritance ,
- infections , and
- an overactive immune system .
Treatment programs, when possible, are often directed toward the precise cause of the arthritis.
More than 21 million Americans have osteoarthritis. Approximately 2.1 million Americans suffer from rheumatoid arthritis.
Risk factors for arthritis include the following:
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