Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a condition that arises from pressure on the main nerve to the hands and fingers, which in turn causes pain, numbness or weakness in the middle fingers and thumbs.

The term "carpal tunnel" refers to a passageway surrounded by bone and ligament found on the palm side of the wrist. About the diameter of the thumb, the carpal tunnel serves as a protective sheaf for the median nerve. Known as a mixed nerve, it has a dual function of supplying sensory information from the fingers to the brain and relaying motor commands to the fingers.

CTS occurs when for any number of reasons the tunnel narrows and exerts pressure on the median nerve. This narrowing most often occurs from swelling in the lubricating layers of the tendons that make up the tunnel. In rare cases, bone spurs may also impinge upon the nerve.

Although the cause of the tendon swelling isn't fully known, most researchers believe a number of conditions - rheumatoid arthritis, diabetes or menopause among them - heighten the opportunity for CTS to occur. Repetitive flexing and extending of the tendons in the hands and wrists (from using power tools, for example, or long-term use of a computer keyboard or mouse) have been shown to increase pressure on the carpal tunnel.

CTS patients usually first notice a vague ache in the wrist that may radiate to the hand or forearm. This may follow over time by tingling or numbness in the thumb and all the fingers except the little finger. Other symptoms include radiating pain and weakness with a tendency to drop objects.

Common Treatments:

Treatment goals focus on relieving pain and the impingement of the nerve. In addition to non-steroidal anti-inflammatory drugs (NSAIDs), physicians may prescribe injections of corticosteroids to relieve pain and pressure.

Sometimes an occupational therapist may be employed to help modify work or task activities, the usual cause of CTS. Physicians may also recommend splinting to immobilize the wrist and force it to rest. In some cases, surgery is a viable option for relieving pressure on the nerve.
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