Carpal Tunnel Syndrome

Carpal tunnel syndrome is a term that is well known. Unfortunately, given this widespread familiarity, people often attribute any discomfort or pain in the hand or wrist to carpal tunnel syndrome. Carpal tunnel syndrome is quite common, affecting 4-10 million Americans, and usually very treatable. However, there are many other conditions which can cause similar complaints. It is important to know the difference.

Fast Facts:

• The main symptom of carpal tunnel syndrome is numbness of the fingers.
• Carpal tunnel syndrome may interfere with hand strength and sensation, and cause a decrease in hand function.
• Carpal tunnel syndrome can be treated effectively with medications, splinting, steroid injections in the wrist and/or surgery.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is pain, tingling, and other problems in your hand because of pressure on the median nerve in your wrist.

The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel. The median nerve controls movement and feeling in your thumb and first three fingers (not your little finger).

What causes Carpal Tunnel Syndrome?

Pressure on the median nerve causes carpal tunnel syndrome. This pressure can come from swelling or anything that makes the carpal tunnel smaller. Things that can lead to carpal tunnel syndrome include:
• Illnesses such as hypothyroidism, rheumatoid arthritis, and diabetes.
• Pregnancy.
• Obesity.
• Making the same hand movements over and over, especially if the wrist is bent down (your hands lower than your wrists), or making the same wrist movements over and over.
• Wrist injuries and bone spurs.
• Smoking, because it can reduce blood flow to the median nerve.

How is Carpal Tunnel Syndrome diagnosed?

The diagnosis of carpal tunnel syndrome often is made by the physician based on an accurate description of the symptoms. During physical examination, testing may identify weakness of the muscles supplied by the median nerve in the hand, including some thumb muscles affected by the syndrome. There may be decreased sensation in the hand to pin prick or light touch. Bending the wrist to 90 degrees for one minute may cause symptoms to appear in the hand (Phalen test) or tapping on the wrist with a reflex hammer may cause an electric shock-like sensation (Tinel Sign). Late in the disease, there may be thinning of the muscles or muscle atrophy at the base of the thumb.

Your doctor may suggest tests, such as:
• Blood tests to see if any health problems might be causing your symptoms.
• Nerve testing to find out if the median nerve is working as it should.



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