Carpal Tunnel Syndrome
The carpal tunnel is a narrow passageway on the palm side of your wrist. It houses the flexor tendons that let you bend your fingers and the median nerve that provides sensation to most of your fingers and hand. Special tissues surround and lubricate the flexor tendons, allowing smooth finger movement. Carpal tunnel syndrome occurs when this tissue swells and narrows the limited space in the tunnel, pinching the median nerve.
Some people are born with narrower carpal tunnels. For others, narrowing of the tunnel and the pinched nerve can be caused by repetitive hand and wrist movements, conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, gout, overactive pituitary gland, hormonal changes, or the presence of a cyst or tumour can exacerbate symptoms. The condition can also be triggered by wrist injuries, fractures or sprains.
Symptoms of the condition can become worse at night and can include:
- numbness and tingling in the thumb, index and middle fingers
- pain and burning in the hand and wrist that radiates up the arm to the elbow
- decreased sensation and weakness in the hand with diminished grip strength
Diagnosis and Treatment Options
Carpel tunnel syndrome is diagnosed by performing a detailed medical history and physical examination. Further tests might include an x-ray and blood tests to rule out underlying medical conditions such as diabetes, arthritis and thyroid problems. You may be referred to a Neurologist for nerve conduction studies to assess the electrical activity in your nerves and muscles.
For cases where surgery is required a small incision is made in the wrist, or at the wrist and also the palm. A thin, flexible tube with a camera (endoscope) is inserted and helps the doctor to see the internal ligaments and structures at the wrist. The ligament is cut, releasing the pressure on the median nerve. The ligament heals through scar tissue that develops after the operation.