Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a series of characteristic symptoms and signs that occurs following the entrapment of the median nerve within the carpal tunnel. The carpal tunnel is a narrow passage way surrounded by carpal bones (wrist bones) and ligaments at the level of wrist through which nerves and tendons pass. One of these nerves passing through the carpal tunnel is the median nerve (running from the forearm into the hand), supplying nerve stimulus from the brain to the thumb, index and middle fingers, and half of the ring finger.

Carpal tunnel syndrome is primarily caused by elevated pressure in the carpal tunnel resulting in the compression of the median nerve. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed. Possible causes of Carpal Tunnel syndrome include:

* Increasing age.
* Genetics
* Square-shaped wrist.
* Female Gender
* Family susceptibility (e.g., square wrist, stature).
* Inherited medical conditions are associated with CTS (e.g., diabetes, hypothyroidism).
* Wrist fractures and dislocations.
* Crush injuries.
* Inflammation around tendons.
* Diseases like Rheumatoid Arthritis.
* Fluid retention in the wrist joint.
* Certain occupational activities.
* Pregnancy.

The Groups Of People Most Likely To Develop Carpal Tunnel Syndrome

* Female to male ratio is up to 10:1.
* Mean age of development of CTS is between 45-60 years.

The patient with Carpal Tunnel Syndrome is likely to experience some of the following symptoms:

* Numbness, burning, or tingling in one or more of the fingers.
* Loss of grip strength, often associated with dropping things.
* Pain (at the nerve distribution site).
* Tight or swollen feeling in the hands.
* Temperature changes (e.g., hands being cold/hot all the time).
* Complaints of changes in sweating, sensitivity to temperature changes (esp. cold) and skin discoloration of the affected hand .

The symptoms of Carpal Tunnel Syndrome may first appear gradually in one or both hands, especially during the night, since many people sleep with their wrists flexed. Patients may also experience the symptoms on performing everyday tasks. As symptoms worsen, they may also feel a tingling sensation throughout the day. Carpal Tunnel Syndrome usually doesn’t cause significant disfigurement .However the muscle group in the hand called the Thenar muscles (supplied by median nerve) located just below the thumb can begin to waste away, giving a flattened appearance to the palm.
Carpal Tunnel Syndrome Can be treated as follows:

CONSERVATIVE TREATMENTS OF CARPAL TUNNEL SYNDROME :

* Treating the underlying cause?
* Resting the affected hand and wrist for at least 2 weeks.
* Avoiding activities that worsen symptoms.
* Immobilization of the wrist with a splint.
* Applying cold packs (to reduce swelling).

MEDICAL TREATMENT OF CARPAL TUNNEL SYNDROME :
* Drugs directed against pain, various analgesics.
* Non steroidal anti-inflammatory drugs, such as aspirin, ibuprofen.
* Diuretics can decrease swelling.
* Steroids may be injected directly into the wrist or taken by mouth to relieve pressure on the median nerve.

SURGICAL INTERVENTION FOR CARPAL TUNNEL SYNDROME :
Patients whose condition do not improve following conservative treatment and patients who experience severe Carpal Tunnel Syndrome symptoms may need surgery.

The Possible Complications Of Carpal Tunnel Syndrome are:
* Permanent impairment and disability.
* Chronic wrist and hand pain

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