Weakness, numbness, and shooting pain that radiates from your hand area up your arm – and which can happen during the day but can also wake you from sleep – may be symptoms of a common issue with your hands called carpal tunnel syndrome. We all have heard of someone we know who suffers from carpal tunnel syndrome, but what is it, what causes it, and how is it treated?
What Is Carpal Tunnel Syndrome?
In your hand and arm, you have nerves, bones, muscles, ligaments, and tendons which assist you in moving your fingers or grasping an object. The major nerve that enables these movements is the median nerve.
This nerve runs through your arm and through the wrist and to the fingers – all fingers except the pinkie. When the median nerve is compressed due to inflammation or repetitive motion, carpal tunnel syndrome usually occurs.
What Are the Common Causes of Carpal Tunnel Syndrome?
Most of us have heard of repetitive movements causing carpal tunnel syndrome, such as typing, but this is not the only cause. Other common causes of this syndrome are:
- The anatomy of your wrist
- Your sex
- Inflammatory conditions
- Trauma to the wrist
- Body fluid changes
- Workplace factors
For most people, there isn’t just one cause of carpal tunnel syndrome, but rather a combination of causes. Let’s take each of these common causes and discuss how they impact your wrist.
The anatomy of your wrist, your sex, and hereditary reasons, all are impacted by the same thing. Women suffer from carpal tunnel syndrome more often than men do, because women tend to have smaller wrists and therefore smaller carpal tunnels. The anatomy of your wrist may adversely affect the median nerve due to its compact size, but there also may be other factors such as deformities.
Inflammatory conditions, such as osteoarthritis and rheumatoid arthritis, impact the joints and can cause deformity or inflammation and swelling of the lining around the tendons. This swelling can compress the median nerve. Other health conditions which can impact nerves are diabetes and thyroid gland issues.
A broken wrist or broken bones in the hand can cause inflammation, arthritis, or deformities. As a result of this trauma, the carpal tunnel may be changed structurally, and the median nerve can be impacted.
Medications such as chemotherapy also can influence carpal tunnel. Inflammation, swelling, or loss of bone integrity are often side effects associated with chemotherapy.
Another cause of carpal tunnel syndrome is obesity. Similarly, many women experience carpal tunnel syndrome during pregnancy. As your body fluid levels change, such as fluid retention sometimes noted in pregnancy, this fluid retention can play a part in the flare-up of carpal tunnel syndrome. But one difference is that when carpal tunnel syndrome happens during pregnancy, it usually resolves on its own after the child is born.
Workplace factors such as repetitive motions, vibrating tools, assembly lines, and even cold temperatures can create prolonged pressure on the carpel tunnel housing the median nerve, thereby leading to carpal tunnel syndrome.
How Is Carpal Tunnel Syndrome Treated?
Carpal tunnel syndrome can be treated nonsurgically or surgically. The more severe your symptoms, the more invasive the treatment becomes.
Impingement of the median nerve can cause permanent nerve damage, and thereby permanent disability of the hand. Therefore, early diagnosis and intervention are key to preventing any long-term nerve damage.
Nonsurgical interventions can be successful if you have mild to moderate symptoms of carpal tunnel syndrome. Nonsurgical treatments include:
- Bracing or splinting of your wrist to decrease movements that are causing pain and inflammation
- Medications such as ibuprofen to decrease swelling
- Corticosteroid injections into the area to reduce inflammation
- Avoiding activities that make symptoms worse
- Applying an ice pack or cold compress to the affected wrist to decrease inflammation
If your symptoms are severe or don’t respond to nonsurgical interventions, surgery may be the best option for you. You should discuss carpal tunnel surgery with your orthopedic surgeon to determine what would work in your case.
The goal of surgical intervention is to relieve the pressure on the median nerve. During the surgery, a small cut is made into one of the adjacent ligaments, thereby providing a wider space for the median nerve. The ligament will heal with a wider shape, and the space for the median nerve remains.