Carpal tunnel syndrome – causes, symptoms, treatment

TL;DR:

• Carpal Tunnel Syndrome (CTS): Caused by compression of the median nerve in the wrist’s carpal tunnel, leading to tingling, numbness, pain, and muscle weakness in the thumb, index, middle, and parts of the ring finger. Symptoms worsen at night or with repetitive hand movements.
• Causes: Can stem from diseases (e.g., rheumatoid arthritis, diabetes), pregnancy, repetitive tasks (e.g., typing, playing instruments), trauma, or structural abnormalities.
• Diagnosis: Performed via medical history, physical exams, nerve conduction studies, EMG, and imaging (ultrasound/MRI).
• Treatment: Conservative methods include lifestyle adjustments, splints, physiotherapy, corticosteroids, or pain management. Surgery (carpal nerve decompression) is considered for severe cases. Post-surgery rehab is crucial.
• Prevention: Ergonomic workspaces, regular breaks, wrist-neutral posture, strengthening/stretching exercises, and protective gear can reduce risks. Symptoms require specialist consultation.

Carpal tunnel syndrome is a condition that poses significant challenges for many people. This complex problem can lead to a variety of symptoms, limiting daily functioning and significantly affecting quality of life. It is associated with compression of nerves and structures within the wrist, which affects limited hand movement and leads to painful symptoms. Understanding the condition is essential not only for those affected, but also for healthcare professionals, in order to effectively diagnose and coordinate a comprehensive treatment plan.

Carpal tunnel – what is it?

The carpal tunnel is an important anatomical structure within the wrist, through which nerves, tendons and blood vessels pass. It is a tight spatial passageway formed by the wrist and ulna bone, which restricts the movement of structures passing through this area. The condition is classified in the group of compression neuropathies, which is associated with pressure on the medial nerve that runs through the carpal canal. Such pressure on delicate anatomical structures, leads to a variety of symptoms, such as tingling, numbness, burning or pain in the fingers, especially the thumb, index finger, middle finger and partly the ring finger.

Carpal tunnel – causes.

Carpal tunnel syndrome can occur without a clear cause, but usually accompanies various diseases and conditions. ** These include rheumatic diseases such as rheumatoid arthritis, systemic scleroderma, polymyositis, osteoarthritis, polymyalgia rheumatica, gout, as well as so-called storage diseases – mucopolysaccharidoses.** In addition, endocrine gland dysfunctions such as diabetes, hypothyroidism, or acromegaly can also promote the syndrome. Other potential causes include infectious diseases, such as tuberculosis, as well as trauma from a specific job, such as upper limb strain in butchers, musicians who play keyboard instruments, and people who use computer keyboards, such as programmers. In addition, carpal tunnel syndrome can be associated with other conditions and diseases, such as localized ganglions, hematomas, adipomas or osteosarcomas, amyloidosis, bone fractures, osteomyelitis, muscle developmental abnormalities, and even pregnancy, especially with swelling, usually in the third trimester. Daily habits, which we are often unaware of, promote the development of signs of carpal tunnel syndrome. These include, for example, repetitive uniform movements of the fingers and hands when operating a computer mouse or doing minor handwork.

Carpal tunnel – symptoms

**The characteristics of carpal tunnel syndrome are mainly manifested by unpleasant sensations in the region of the thumb, index finger and half of the ring finger. These uncomfortable sensations include tingling, numbness and discomfort. As a result, muscle weakness is common, sometimes even with muscle atrophy. Patients experience difficulty in precise activities related to the affected area. They feel that the strength of the muscles in the hand is weakened, manifesting as difficulty clenching the hand into a fist. They find it challenging to work on the computer, write or perform everyday household tasks. Symptoms worsen especially at night, especially when the hand is raised. The tingling and numbness are often so annoying that individuals wake up during the night in an attempt to relieve the discomfort. Such people also have difficulty when performing activities that require repetitive bending or lifting movements of the hand, such as holding a phone or driving a car. Initially, symptoms may appear sporadically, but over time they become more frequent, and in some patients they persist permanently. Some patients experience temporary improvement when they shake their wrist, and when they pour warm water over their hands.

Diagnosis and diagnosis of carpal tunnel syndrome

Diagnosis of the syndrome involves a series of steps to establish an accurate diagnosis. After observing any symptoms in yourself that suggest this disorder, you should see a doctor. He or she will conduct a detailed medical history and physical examination, which includes assessing muscle strength, sensation, and checking joint and finger mobility. The doctor may use a variety of tests to assess sensation and muscle strength in the hand, such as nerve tapping and wrist flexion tests, which can usually identify the affected areas.

Other tests, such as electromyography (EMG) and nerve conduction studies, are also helpful in diagnosis. These help assess nerve and muscle function, which can aid in the diagnosis of carpal tunnel syndrome. Similarly, imaging studies such as MRI or ultrasound are used to evaluate anatomical structures in the hand and rule out other causes of the condition. Wrist usg If in doubt, the doctor may refer the patient to a specialist, such as a neurologist or orthopedist, for a more advanced evaluation and confirmation of the diagnosis.

Carpal tunnel – treatment.

Depending on the duration and severity of the condition, the doctor selects the appropriate treatment for carpal tunnel syndrome. Conservative methods are mainly based on lifestyle changes and modification of daily activities, such as avoiding repetitive wrist bending gestures, which can help relieve symptoms. In addition, specialized physiotherapy exercises help strengthen muscles, improve joint mobility and relieve tension. Sometimes the doctor may recommend wearing a special splint at night or during repetitive maneuvers to keep the entire hand in the correct position and reduce pressure on the nerves. Conservative treatment also involves injecting corticosteroids or taking them orally. If the affected person has mild manifestations of the condition, improvement is usually seen after about 2-6 weeks. The best results are seen after about 3 months. While it is possible to completely cure carpal tunnel, it is important to remember that if the condition coexists along with a chronic disease, symptoms may recur.

Carpal tunnel – surgery.

Carpal tunnel syndrome surgery, also known as carpal nerve decompression, may be considered when manifestations do not resolve after conservative methods or when there is an advanced degree of compression. Preparation for surgery involves consultation with a doctor, who will conduct a detailed assessment of the patient’s condition, make a diagnosis and decide whether surgery is necessary. The aforementioned preoperative examinations – including blood tests and imaging tests – can be helpful in the diagnosis. During the surgery, the patient is put under general or local anesthesia with painkillers. The surgeon removes part or all of the carpal tunnel fascia to release pressure on the nerve. In some cases, the cord may need to be widened to create more space. After surgery, a dressing is placed, which may include stabilizing splints.

Rehabilitation is key to returning the hand to full function. The person being treated is usually referred for physiotherapy, which includes exercises to strengthen, stretch and improve range of motion. If necessary, the doctor prescribes painkillers to relieve discomfort after surgery. During the recovery period, the patient should avoid overexerting the operated hand and follow the doctor’s recommendations for range of motion. The healing process should also be monitored and regular check-ups with a specialist should be carried out. Operation for carpal tunnel syndrome often provides relief for persistent symptoms and difficulties in daily activities. However, each case is unique, and the decision to operate is made by the doctor based on the client’s individual needs and clinical evaluation.

Prevention, or how to avoid the onset of carpal tunnel symptoms?

While it is impossible to completely protect against the onset of carpal tunnel syndrome, there are some preventive steps that can help reduce the risk or alleviate symptoms. These include:

• workplace ergonomics – make sure your workstation is well suited to your needs. Choose ergonomic accessories, such as a computer keyboard and mouse, to reduce the strain on your hands,
• take regular breaks and exercise – if you perform repetitive motions, such as typing or using a computer, take regular breaks to stretch and relax your muscles,
• Maintain correct posture – take care to maintain correct posture when performing various activities. Try to keep your wrist in a neutral position,
• strengthening and stretching exercises – regularly performing strengthening and stretching exercises for the hand muscles can help keep them flexible and strong,
• Wear appropriate protective equipment – if you have a job that puts excessive strain on your wrist, such as when doing physical activities, wearing special bands or splints can help protect the joint,
• regular checkups – can help detect possible problems early and take preventive measures.

Following these recommendations does not guarantee complete avoidance of carpal tunnel syndrome, but can significantly reduce the risk of symptoms. If you have any complaints or concerns, it is always advisable to consult a specialist.

Conclusion

Carpal tunnel syndrome disrupts life with pain, weakness, and limited hand use. Understanding its causes, symptoms, and treatments is essential for managing or preventing it. From lifestyle changes to surgical intervention, solutions exist based on severity. Prevention through ergonomic habits and regular exercises can reduce risks, though no method guarantees complete avoidance. Early diagnosis and treatment improve outcomes, so don’t ignore symptoms. Taking proactive steps ensures you maintain better hand health and function, enhancing overall quality of life.