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Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

It is a painful and progressive condition resulting from compression of the median nerve as it passes through the carpal tunnel in the wrist.

How do I know I have carpal tunnel syndrome?

Usually symptoms come on slowly and becomes progressively worse. It may be worse at night, particularly if you tend to sleep with your wrists flexed, with your palm bent down towards the front of your forearm. These symptoms include:

  • Tingling and numbness in the fingers and palm of your hand that feels like ‘pins and needles’
  • Pain in your wrist or hand, which can radiate up the arm to your elbow or down to your fingers
  • Pain that can vary from a dull, aching sensation, through to a burning feeling, or a sharp, piercing or shooting pain, like a very bad cramp
  • The pain and discomfort can often be relieved by shaking out the hands (like you are flicking water off your hands)
  • A sensation that your fingers are swollen, even if they look normal in size
  • A feeling of weakness in your hands or a loss of grip strength, which can make it difficult for you to hold small objects, clench your fist, or carry out your usual tasks.

What causes carpal tunnel syndrome?

Narrowing of the carpal tunnel from various factors could result in the compression of the median nerve as it passes through the tunnel. Some people also develop carpal tunnel syndrome without any unknown risk factors. The known factors may include:

  • Trauma or injury to the hand or wrist that results in swelling, such as a sprain or a bone fracture

  • Some diseases, such as rheumatoid arthritis, diabetes, or disorders of some glands, such as the thyroid or pituitary gland

  • A cyst or tumour in the carpal tunnel

  • Retaining extra body fluid during pregnancy or menopause. Carpal tunnel syndrome during pregnancy usually develops in the second and third trimesters, and normally disappears within a month after giving birth

  • Being overweight

  • Activities or jobs that involve repetitive movements of the wrist and hand, or using machinery or tools that cause excessive vibration

  • Being female – women are 3 times more likely to develop carpal tunnel syndrome than men, possibly because women generally have a narrower carpal tunnel

  • A family history of carpal tunnel syndrome.

Do I need treatment for carpal tunnel syndrome?

Yes. If left untreated, the excessive pressure on the median nerve can cause the muscles near the base of the thumb to waste away. Treatment usually includes:

  • Rest and patient education

  • Night wrist splint

  • Physiotherapy

  • Ergonomic assessment

  • In some cases, surgery

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