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.
Myth: Getting Carpal Tunnel Surgery Means Missing Work For A Long Time
Many people are hesitant to consider carpal tunnel release because they fear losing use of their hand for weeks or even months, or they dont feel they can take enough time off work. But the recovery period for carpal tunnel release can be relatively quicklight non-repetitive use of the hand is permitted after about a week, when the bandage is removed.
In fact, those who have jobs with minimal involvement of the affected hand may return to work in a week or two. This may be particularly true for those who receive the endoscopic approach. A splint may still be needed occasionally to support the wrist, especially at night.
Patients who had the procedure in their dominant hand or who perform repetitive labor, such as an assembly line worker, may need to wait six to eight weeks before returning to work. After two or three months, most patients will experience the return of grip and pinch strength and can resume heavy use of the hand.
Pain After Carpal Tunnel Surgery Due To Surgical Failure
Sometimes carpal tunnel pain never totally disappears after surgery. And sometimes it goes away but then comes back again in a few weeks or months.
If you had carpal tunnel release surgery but still feel symptoms, you might be in this unlucky group. Its not unusual to see patients where the surgery didnt live up to its promises.Carpal tunnel doctorsconsider that afailed surgery.
Failed surgeries happen about50% of the time – that’s if you measure “patient satisfaction”. If a surgery fails, the doctor may recommend another,second carpal tunnel release surgery. But the chances of success after a revision surgery isonly 10-59%.
When a carpal tunnel surgery fails, most times the patient simply lives with the remaining symptoms. This also includes coping with the physical, emotional, and financialscarof having a failed surgery.
TheAmerican Academy of Orthopedic Surgeonsreports that over 500,000 carpal tunnel surgeries are performed each year. TheBureau of Labor Statisticsand theNational Institute for Occupational Safety & Healthhave another statistic. They say for those who hadcarpal tunnel release surgery,only20-24% returned to their former jobafter surgery.
– Bleak statistics indeed.
Recommended Reading: Do Blueberries Make You Gassy
Carpal Tunnel Test Process
Many medical professionals work together in the carpal tunnel test process. Primary care physicians, physical therapists, ortho specialists, and others. The carpal tunnel test process is often comprehensive because its important that its diagnosed accurately to ensure proper treatment. Here are the steps included in the carpal tunnel test process. In some instances, only a few of these steps are performed. In others, all may be performed:
- A Thorough Neck and Back Examination
- Grip Strength Tests for Fingers and Hands
- Blood Tests
It is quite likely that you are experiencing shoulder pain that you believe could be caused by carpal tunnel syndrome. Is it carpal tunnel or is it a shoulder issue?
The truth of the matter is, it is probably both stemming from reversed median nerve pain resulting from compression. If you have shoulder pain, it is likely that you are suffering from carpal tunnel syndrome.
In years past, most doctors would not make this correlation. In todays medical landscape, its been found in approximately 75% of all cases of shoulder pain. The root cause is carpal tunnel syndrome. This is especially true among high risk groups.
About Cubital Tunnel Syndrome
Cubital tunnel syndrome is also caused by compression of a nerve in your arm, specifically the ulnar nerve at the elbow. This nerve passes through a tunnel of muscle, ligament, and bone called the cubital tunnel. When this tunnel is inflamed or injured, you experience the symptoms of cubital tunnel syndrome.
Read Also: What Is Neck Stomach Syndrome
Research And Possible Risk Factors
Researchers have found that a previous wrist fracture and the use of insulin, metformin, and sulphonylureas are associated with a higher chance of CTS. Smoking, hormone replacement therapy , the combined oral contraceptive pill, and oral corticosteroids did not appear to be not linked to a higher risk of CTS.
One study has suggested that obesity, combined with a square-shaped wrist shape, may increase the likelihood of CTS developing. However, the team concluded that obesity was probably not the cause, because when participants with obesity lost weight, they continued to have CTS.
The same team concluded in other research that the age of women at the menopause might be a factor, and that pregnancy-related hormones may increase the risk of CTS in women at the time of the menopause.
Apart from work-related factors, the main risk for CTS is inflammatory arthritis, but hypothyroidism and diabetes also appear to of developing it, according to research published in the Journal of General Internal Medicine.
The National Institute of Neurological Disorders and Stroke says that CTS is three times more likely to occur among people working in assembly operations than in data-entry personnel.
The Canadian Centre for Occupational Health and Safety list the following occupations as risk factors for CTS:
According to the National Library of Medicine, there is
Mild Carpal Tunnel Pain
In themildstage of carpal tunnel, pain, numbness or tingling definitely begin to make a showing. These sensations are usually more pronounced in the thumb, index and middle fingers. However, the little finger doesnt show signs whatsoever.
Pain is often accompanied by your fingers feeling puffy, even though theyre not. In over 80% of patients, these sensations occur in both hands within a 6 month period .
The carpal tunnel pain will usually have one or more of the following qualities during the mild stage:
- Deep, dull, aching or throbbing
- Sharp, stinging or stabbing
- Shooting or electrical
In thismildstage, the finger or hand pain is usually intermittent. It’s rarer for pain to be constant in the mild stage.
Also in themildstage, the level of carpal tunnel painis usually described as “annoying”. It’s rarer to describe the pain as “intense”.
Usually pain advances from barely noticeable to intense within 6 months. This is when it reaches the moderate stage.
Another characteristic ofmildstage carpal tunnel pain or numbness is it usually happens while you try to sleep at night. In fact, one of the hallmark symptoms ofmildcarpal tunnel syndrome is that you have to wake up to “rub out” the pain or “shake out” the numbness.
Many patients first notice pain or numbness whendriving their car.Holding the steering wheel causes pain, numbness or tingling in the palm or fingertips. Likewise, holding a phone up to the ear causes similar symptoms to appear.
Don’t Miss: Pineapple Juice Stomach Ache
Is My Hand Pain From Carpal Tunnel Syndrome Or Something Else
We all wake up sometimes with a numb and tingly hand. But ongoing hand pain and numbness can be a disabling problem that requires diagnosis and treatment.
Here are 3 of the main causes of hand pain and numbnessand tips for how you can tell them apart.
The median nerve can be irritated in the carpal tunnel at the wrist or at its origin in the cervical spine. Learn more: Carpal Tunnel Syndrome vs. Cervical Radiculopathy
Description Of Carpal Tunnel Syndrome
Under normal circumstances, the median nerve passes through the carpal tunnel, without incident. The tunnel, located near the base of the wrist, sometimes narrows, as a result of inflammation or injury. Carpal tunnel syndrome symptoms appear when the median nerve becomes constricted as it passes through the opening.
Read Also: Iv Lidocaine For Pain
Surgery For Carpal Tunnel Syndrome
If surgery is needed, it’s typically done on an outpatient basis under local anesthesia . The ligament overlying the top of the carpal tunnel is cut to relieve pressure. The healed ligament will allow more space in the carpal tunnel. Sometimes the procedure is done endoscopically, using a tiny camera inserted through a very small incision to guide the procedure.
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.
Don’t Miss: Diagnosing Knee Pain Symptoms
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.
Minimizing Stress With Carpal Tunnel Syndrome
As a carpal tunnel syndrome sufferer, there are many ways to minimize stress in the hand, wrist, arm, and shoulder. First, you should relax the grip that you have to reduce the amount of force you use when using the hands. By relaxing the grip, you will find that muscle fatigue and strain is avoided.
When using the hands, it is best to take frequent breaks. The wrists should be kept in a neutral position at all times. You may also work to improve your posture.
Additionally, there are many at home tools you can use to ease pain and heal your shoulder. This can aid in healing carpal tunnel syndrome.
Don’t Miss: Slitted Wrists
What Causes Repetitive Strain Injury
There is no fundamental event that usually leads to RSI. Instead, the disorder is often the end result of months of subtle exertion mild impact repetitive task involving the hand, wrist, and finger muscles.
Interestingly, Type-A personalities and individuals characterized as perfectionists tend to come down with repetitive strain injury with a higher incidence that the overall population. Since they are so driven to perform, their non-functioning hands tend to cause more psychological stress, which is itself, ironically, a serious contributor to carpal tunnel syndrome, a common form of RSI.
Usually repetitive stress sufferers find themselves in a vicious cycle of one kind or another, which brings on the syndrome.
One of the frustrating things about enduring chronic hand pain is that friends, co-workers, and family members may not recognize the extent to which a person has been injured. Until one has experienced a repetitive stress disorder, it is hard to imagine that such low impact tasks could result in such chronic dysfunction.
This misunderstanding by bosses, friends and family also adds to the psychological stress and actually contributes to the cycle of pain.
Even doctors and hand therapists may not have the insight to identify the very subtle causes and ergonomic factors associate with RSI in some cases, but they can be very helpful in an accurate diagnosis and identifying complicating metabolic factors that might need to be addressed separately.
Where Carpal Tunnel Pain Hurts The Most
Exactly where carpal tunnel pain hurts the most varies from person to person. That’s because everybody experiencessymptoms of carpal tunnel syndromea little differently.
In general, pain is usually themajorsymptom, followed by numbness and tingling . The pain can be on any finger except the little finger. It can also include the entire palm of the hand and even the wrist. Sometimes pain shoots from the fingers, through the hand and up the arm.
You might also be interested in:
Recommended Reading: Lidocaine Cream For Sciatica
Types Of Painful Feelings
As describe above, theplacewhere carpal tunnel pain hurts the most is easy to define. But describing the actualtypeof pain patients feel is more difficult.
The types of pain reported have a wide range. They can be anywhere fromannoying or bothersometocrushing or punishing. The specificqualitiesof pain sensations usually described are:
Note that you can have only one or all of these pain sensations at the same time. Usually having more than one type of pain sensation is relative to the stage of carpal tunnel syndrome.More advanced stages produce additional types of pain sensations.
Symptoms Of Carpal Tunnel Syndrome
The two classic symptoms of carpal tunnel syndrome are pain, numbness, and/or tingling that:
- Affects the thumb, index and middle fingers. You may also feel it a bit in your ring finger, but not your pinky finger
- Wakes you up at night or is worse in the morning
Other symptoms of carpal tunnel include pain, numbness, and tingling that:
- Feels better if you change your hands position or shake or wring your hands
- May extend up your forearm
- Develops or gets worse when you flex your wrist 90° for 1 minute or longer
You may also notice that pressing on your wrist causes pain.
Read more about Carpal Tunnel Syndrome Symptoms on Sports-health.com.
What causes carpal tunnel syndrome symptoms The pain and other symptoms of carpal tunnel occur when the median nerve is inflamed or irritated. The median nerve controls the sensation in your thumb, index finger, and middle finger. It travels through a narrow space at the center of the wrist called the carpal tunnel. If the tendons that also run through the carpal tunnel become inflamed, carpal tunnel syndrome can develop.
Other less common conditions can cause chronic numbness and tingling in the hands, including but not limited to cervical spine disorders, such as cervical radiculopathy.
Read more about Cervical Radiculopathy on Spine-health.com.
You May Like: Neck Pain And Vomiting
What Is The Carpal Tunnel
The carpal tunnel is a narrow canal or tube in the wrist. Similarly to a tunnel you could travel through by car, this part of the wrist allows the median nerve and tendons to connect the hand and forearm. The parts of this tunnel include:
- Carpal bones: These bones make up the bottom and sides of the tunnel. They are formed in a semi-circle.
- Ligament: The top of the tunnel, the ligament is a strong tissue that holds the tunnel together.
Inside the tunnel are the median nerve and tendons.
- Median nerve: This nerve provides feeling to most of the fingers in the hand . It also adds strength to the base of the thumb and index finger.
- Tendons: Rope-like structures, tendons connect muscles in the forearm to the bones in the hand. They allow the fingers and thumb to bend.
Types Of Pain After Carpal Tunnel Surgery
Immediate pain after carpal tunnel surgery is perfectly normal – and expected. The pain’s intensity usually is related to the type of surgery you have:
- Pain normally is more intense with theopen release type of surgery.
- Theendoscopic releasetype of surgery normally results in less pain.
But regardless of which type of surgery you have, painwillhappen. And will be most intense within the first week. This is a normal outcome of both surgery types.
Most of yourrecoveryandaftercarewill revolve around managing the pain. In general, you’ll experience 2 types of pain after either carpal tunnel surgery. Again, both are perfectly normal. Namely, they’re referred to as:
Don’t Miss: Why Do People Cut There Wrist
Symptoms Of Arthritis In The Hand
Many different types of arthritis can affect the hand. If you have any type of hand arthritis, you may notice joint pain and:
- Swelling in your wrists, fingers, and/or knuckles
- Redness and warmth in the skin over your wrist and knuckle
- Nodes or bony growths at or near the affected joints of the hands
- Symptoms that are worse in the morning or after lots of activity
Read more about Recognizing Osteoarthritis in the Hand
Carpal tunnel syndrome can also cause symptoms that are worse in the morning, so that is not necessarily a distinguishing symptom.
Can Carpal Tunnel Syndrome Be Prevented Or Avoided
You can take steps to prevent carpal tunnel syndrome. The following actions may help to prevent it:
- Lose weight if youre overweight.
- Get treatment for any disease you have that may cause carpal tunnel syndrome.
- If you do the same tasks over and over with your hands, try not to bend, extend, or twist your hands for long periods of time.
- Dont work with your arms too close or too far from your body.
- Dont rest your wrists on hard surfaces for long periods of time.
- Switch hands during work tasks.
- Make sure the tools you use arent too big for your hands.
- Take regular breaks from repeated hand movements to give your hands and wrists time to rest.
- If you use a keyboard a lot, adjust the height of your chair so that your forearms are level with your keyboard, and you dont have to flex your wrists to type.
Many products you can buy, such as wrist rests for a computer keyboard, are supposed to ease symptoms of carpal tunnel syndrome. No one has proven that these products really prevent wrist problems. Some people may have less pain and numbness after using these products, but other people may have increased pain and numbness.
Don’t Miss: Tramadol Sciatica