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Pain which occurs anywhere in the middle finger can have many characteristics and be caused by just as many conditions.

These issues can include injury to the finger, osteoarthritis, rheumatoid arthritis, etc., but the most common of these causes is carpal tunnel syndrome (CTS)

Carpal tunnel syndrome 

The carpal tunnel is a pathway which is found on the palm side of the wrist, and is a structure bound by ligaments and the carpal bones of the wrist.

Symptoms are experienced by patients when this carpal tunnel starts to narrow and the median nerve, which runs through it, becomes compressed.

Symptoms

The symptoms of CTS usually start slowly and then gradually get worse over time as the space in the carpal tunnel narrows. They may include the following:

  • Numbness or tingling sensation - patients report that they experience these issues in one or both hands. It will involve the thumb, index and middle-fingers of the hand which are the fingers which are supplied by the median nerve. This sensation can refer up the arm and patients say that they find relief when they shake out their hands.
  • Weakness - patients may experience weakness in the hands, to the point where they start to drop objects.
  • Pain - the affected part of the hand can start getting painful when the compression of the median nerve becomes persistent and continuous.

Causes

In many cases, no single cause can be found which results in this issue. The main reason behind CTS is compression of the median nerve. 

Therefore, any issue which results in irritation, compression or crowding of the median nerve would be the suspected primary cause.

Possible examples would then include:

  • Previous trauma to the wrist.
  • Rheumatoid arthritis.
  • Inflammation of the tissue in the carpal tunnel due to persistent use of the wrist. 

Risk factors

These issues don't directly cause CTS, but they may increase the risk of developing this condition. They include:

  • Gender - CTS generally occurs more in women. This could be due to the fact that the carpal tunnels in women are smaller than in men.
  • Anatomical factors - smaller carpal tunnels will be prone to experience more space-occupying issues when there's previous trauma or inflammation present in or around the wrist.
  • Inflammatory diseases - such as being diagnosed with rheumatoid arthritis.
  • Nerve-damaging conditions - diabetes increases the chances of damage to nerves, as well as the median nerve.
  • Workplace factors - the use of vibrating tools or equipment which requires bending of the wrist for prolonged periods of time may also lead to CTS.
  • Other medical issues - obesity, thyroid diseases, kidney failure and menopause may all increase the risk of developing CTS.

Management

CTS can be managed through conservative or surgical methods.

Conservative methods may include the use of wrist splints and anti-inflammatory medications such as steroids and non-steroidal anti-inflammatories.

Surgical methods are performed if conservative therapy fails. These can include performing laparoscopic surgery or open surgery, where the ligament of the carpal tunnel is cut in order to take pressure off the median nerve.

 

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