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Carpal tunnel syndrome is a common, painful defect of the wrist and hand.

What is carpal tunnel syndrome?

If you have Numb hands you may have Carpal tunnel syndrome.  It is caused by pressure on the middle nerve in the carpal tunnel. The syndrome is seen more often in women, especially in pregnant and in menopausal women. Symptoms may result from a blow, swelling, a tumor, rheumatoid arthritis, or a small carpal tunnel that squeezes the nerve. The middle nerve (median nerve) serves the palm and the thumb side of the hand. The median nerve carries signals from the brain to control the actions of the fingers and hand. Pressure on this nerve can injure it.

The injury results in sensations of numbness, tingling, pain, and clumsiness of the hand. This combination of symptoms is called Carpal tunnel syndrome. People with carpal tunnel syndrome experience difficulty in performing tasks such as unscrewing bottle tops, fastening buttons, or turning keys.  Pressure on the nerve causes numbness, tingling, and pain in the arm, hand, and fingers, weakness, pain when the thumb is bent toward the palm, and burning, or aching that may spread to the forearm and the shoulder. Weakness and wasting of muscles may occur from lack of use, getting in the way of full use of the thumb and fingers. Pain may be infrequent or constant and is often most intense at night. Drugs given by injection often bring quick relief from bad pain. An operation to relieve nerve pressure usually corrects the syndrome for good.

Tingling sensation and decreased functioning in the wrist, hand, and fingers resulting from compression of the median nerve

What are causes of carpal tunnel syndrome?

The exact cause is unknown, but highly repetitive flexing motions of the wrist are strongly implicated. Conditions that cause edema (e.g., diabetes, pregnancy, congestive heart failure, and renal failure) also have been suggested as causes. One theory links carpal tunnel syndrome to a vitamin B6 deficiency in conjunction with repetitive movements. Thyroid conditions and rheumatoid arthritis also can be associated with carpal tunnel syndrome. Some individual factors, such as the size and shape of the wrist and the shape of the median nerve, may cause development of carpal tunnel syndrome.  The incidence of carpal tunnel syndrome has increased dramatically over the past decade; it is one of the three leading occupational-related conditions. It occurs most often in women.

Occupational factors of carpal tunnel syndrome

Carpal tunnel syndrome could be related with certain tasks like: repetitive hand motions, vibration, awkward hand positions, strong gripping, vibration and mechanical stress on the palm.
Disease Process

The median nerve in the volar aspect of the wrist is compressed between the longitudinal tendons of the forearm muscles that flex the hand and the transverse superficial carpal ligament. This causes paresthesias in the thumb, forefinger, and middle finger and half of the ringfinger. There are six key risk factors in the workplace for the development carpal tunnel syndrome. They include: repetition, high force, awkward joint posture, direct pressure, vibration, and prolonged constrained posture.

Other factors of carpal tunnel syndrome

Other risk factors include: previous injuries, cigarette smoking, poor nutrition, and stress can increase one's risk for carpal tunnel syndrome.

What are the symptoms of carpal tunnel syndrome?

In most of cases symptoms usually start gradually, with pain, weakness, or numbness in the hand and wrist, radiating up the arm. Symptoms include pain, weakness, clumsiness, numbness, heaviness, numbness, burning, and tingling in one or both hands are the usual manifestations. If you have carpal tunnel syndrome you may drop objects or be unable to use keys or count change with the affected hand. Your skin may be dry because of reduced sweating. The pain may be worse at night and lessen during the day unless the person's activities require repetitive wrist flexion. The pain may radiate to the shoulder and forearm. In some cases, sensation may be permanently lost and the muscles at the base of the thumb slowly shrink (thenaratrophy), causing difficulty with pinch.

What are complications of carpal tunnel syndrome?

If left untreated in some severe cases carpal tunnel syndrome can cause permanent nerve damage with loss of sensation and movement.

How carpal tunnel syndrome is diagnosed?

Diagnosis of carpal tunnel syndrome is confirmed by performing certain tests to detect damage to the median nerve. Clinical evaluation with characteristic signs, inability to make a fist, positive Tinel's sign (tingling and burning produced by light tapping over the tendon sheath on the ventral surface of the wrist), positive Phalen's sign (pain or numbness after 30 seconds of wrist flexion), wasting around fingernails; history of repetitive use, underlying disease, last trimester of pregnancy; weakened muscle response on electromyogram. An x-ray may be taken to check for the other causes such as arthritis or a fracture.

Treatments

You could have some relive without surgery. Treatment generally includes resting the affected hand and wrist for at least 2 weeks. You should avoid activities that may worsen symptoms.  In some cases , keeping the wrist splinted in a straight position may help reduce pressure on the nerve. Immobilizing the wrist in a splint to avoid further damage could be helpful.  You should change the patterns of hand use. You can use nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other relievers. Those drugs  may ease pain.   A steroid injection also may help to relive numbes and pain. In some severe cases surgery may be needed. There are some alternative therapies, such as acupuncture, to prevent and treat this disorder.

Surgery

Surgery is performed for release of carpal ligament for decompression of nerve if conservative measures are ineffective. Surgery should not be the first choice for treatment.  Surgeon enlarges the tunnel and that decrease pressure on the nerve.  You should know that soreness witch following the surgery, last for couple weeks or months. The numbness in the hand after surgery may despair quickly or slowly. In most of cases it t may take several months the wrist to return to normal. You could have weakness of grip in the operated hand.  In some severe cases Carpal tunnel symptoms may not completely go away after surgery.

How can we prevent carpal tunnel syndrome?

Prevention of carpal tunnel syndrome may involve redesigning work stations. Proper work station design reduced the stressful effects of repetitive motions. Work stations should be accommodating a vast majority of people who work in that area. Informing workers about the risk factors that can contribute to carpal tunnel syndrome is very important.

General

Restriction of repetitive wrist flexion could be successful; Cock-up splints at night to reduce nerve pressure and relieve pain. Recurrence of carpal tunnel syndrome is rare. You will recover completely.  To prevent job related carpal tunnel syndrome, workers can perform stretching exercises, take frequent rest breaks, and use correct posture and wrist position.