What Is Carpal Tunnel Syndrome? What Causes Carpal Tunnel Syndrome?
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Carpal tunnel syndrome (CTS), also called median neuropathy at the wrist, is a medical condition in which the median nerve is compressed at the wrist. It is a relatively common condition that causes pain, numbness and a burning or stinging sensation in the hand and fingers. Symptoms of CTS can range from mild to severe.
According to the journal Plastic and reconstructive surgery (Volume 105(5)April 2000pp 1662-1665), approximately 1% of the US population and 5% of the US working population who must undergo repetitive use of their hands and wrists in daily living are affected by Carpal Tunnel Syndrome.
Over 463,000 carpal surgery releases (surgeries) are performed annually in the United States, accounting for $1 billion in direct costs.
According to Medilexicon’s medical dictionary:
Carpal tunnel syndrome is “the most common nerve entrapment syndrome, characterized by paresthesias, typically nocturnal, and sometimes sensory loss and wasting in the median nerve distribution in the hand; often bilateral and affects women more than men; due to chronic entrapment of the median nerve at the wrist within the carpal tunnel.”
The carpal tunnel
The carpal tunnel is a small tunnel bound by bones and ligaments that runs from the bottom of the wrist to the lower palm. This tunnel protects a main nerve to the hand and tendons that bend the fingers. Several tendons that help to move the fingers pass through the carpal tunnel. The median nerve also passes through the tunnel, which controls sensation and movement of the hand.
In cases of carpal tunnel syndrome (CTS), the space inside the tunnel shrinks, placing pressure on the median nerve. Pressure placed on the nerve produces the numbness, pain and, eventually, hand weakness that characterize carpal tunnel syndrome.
The condition was first noted in medical literature in the early 20th century, but the first use of the term “carpal tunnel syndrome” was in 1939.
While it might seem that carpal tunnel syndrome is a condition caused by long hours spent working on a computer keyboard, carpal tunnel syndrome actually has numerous causes.
Fortunately, proper treatment can usually relieve the pain and numbness and restore normal use of wrists and hands.
How common is CTS?
Carpal tunnel syndrome is one of the most common conditions affecting the nerves of the hand. Most cases develop in people who are between 45 and 64 years of age.
CTS is also common in pregnant women. This may be due to the fluid retention that typically occurs during pregnancy, placing additional pressure on the carpal tunnel.
Outlook
Cases of CTS that occur during pregnancy usually resolve after the birth.
If left untreated, CTS may lead to permanent nerve damage.
What are the signs and symptoms of carpal tunnel syndrome?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom, while dilated pupils may be a sign.
Typically, carpal tunnel syndrome starts gradually with a vague aching in the wrist that can extend to the hand or forearm. Many people who have carpal tunnel syndrome have gradually increasing symptoms over time. The first symptoms of CTS may appear when sleeping, and typically include numbness and paresthesia (a burning and tingling sensation) in the thumb, index, and middle fingers. Other common carpal tunnel syndrome symptoms include:
Tingling or numbness in the fingers or hand, especially the thumb and index, middle or ring fingers. The little finger is not affected. Many people shake their hands to try to relieve their symptoms. As the disorder progresses, the numb feeling may become constant.
Pain radiating or extending from the wrist up the arm to the shoulder or down into the palm or fingers. The pain is present especially after forceful or repetitive use. This usually occurs on the palm side of the forearm.
A sense of weakness in the hands and a tendency to drop objects.
The symptoms of CTS are often worse at night and may disrupt sleep.
Dexterity problems
People who have CTS may find that their hands become weak and clumsy. They also might find it is difficult to grip objects with the thumb.
Similarly, there may be problems when using the affected fingers to carry out tasks that require high levels of manual dexterity, such as typing.
Keeping the hand or wrist in one position or carrying out repetitive tasks, can make the symptoms of CTS worse. However, moving the hand or shaking the wrist can often help to relieve the symptoms.
www.mycarpaltunnel.comIn rare cases, people may also experience dry skin, swelling or changes to the color of the skin in the affected hand.
Seek medical advice if there are persistent signs and symptoms that might be due to carpal tunnel syndrome that interfere with normal activities (including sleep). If the condition is left untreated, nerve and muscle damage can occur.
What are the causes of carpal tunnel syndrome?
The cause of carpal tunnel syndrome is pressure on the median nerve. The median nerve has a sensory function and also provides nerve signals to move the muscles (motor function). The median nerve provides sensation to the thumb, index finger, middle finger and the middle-finger side of the ring finger. The compression of the median nerve can disrupt these nerve signals, which means that both the sense of touch and the ability to move the hand can be affected.
Compression of the median nerve can occur when the tendons that run through the carpal tunnel become inflamed and swollen.
Possible causes include:
Other health conditions. Such as rheumatoid arthritis, certain hormonal disorders (diabetes, thyroid disorders and menopause), fluid retention due to pregnancy, or deposits of amyloid (an abnormal protein produced by cells in the bone marrow).
Repetitive use or injury. Repetitive flexing and extending of the tendons in the hands and wrists. This is particularly the case when done forcefully and for prolonged periods without rest. This can increase pressure within the carpal tunnel. Injury to the wrist can cause swelling that exerts pressure on the median nerve.
Physical characteristics. In some people, the carpal tunnel is more narrow than average.
What are the risk factors of carpal tunnel syndrome?
A risk factor is something which increases the likelihood of developing a condition or disease. For example, obesity significantly raises the risk of developing diabetes type 2. Therefore, obesity is a risk factor for diabetes type 2.
The exact reason why changes to the structure of the carpal tunnel occur in some people is unclear. Some research indicates that carpal tunnel syndrome can result from overuse or strain in certain job tasks that require a combination of repetitive, forceful, and awkward or stressed motions of the hands and wrists. Examples of these include:
Using power tools (such as chippers, grinders, chain saws or jackhammers)
Heavy assembly line work (such as in a meatpacking plant)
Repetitive computer use is commonly assumed to cause carpal tunnel syndrome. However, the scientific evidence for this association is not definitive.
It is not clear which activities can cause carpal tunnel syndrome. If work or hobbies are hand-intensive (involving a combination of awkward, repetitive wrist or finger motions, forceful pinching or gripping, and working with vibrating tools) there may be at higher risk of developing the condition.