The eight bones that make up your wrist form a U-shaped channel that houses several tendons and your median nerve. This channel is called the carpal tunnel. Your median nerve is responsible for sensation on the palm side of your first 3 ½ fingers. When this nerve is compressed or irritated as it travels through the carpal tunnel the condition known as Carpal Tunnel Syndrome (CTS) is formed. CTS is the by far the most common nerve entrapment, affecting 3-5% of the general population. Females are known to be impacted by this condition two or three times more frequently than males. Carpal tunnel syndrome most often is found in adults age 45-60.
CTS can also be brought on by prolonged wrist flexion and/or repetitive wrist movements like supermarket scanning, keyboard use, carpentry or assembly line work. Constant exposure to vibration or cold may also aggravate the condition. Carpal Tunnel Syndrome is also known to be much more common in your dominant hand but also can impact both hands. Some risk factors for developing CTS include diabetes, thyroid disease, rheumatoid arthritis, alcoholism, kidney disease and being short or overweight. Fluid retention during pregnancy is a common cause of carpal tunnel symptoms.
Some common symptoms of CTS include numbness, tingling or discomfort on the palm side of your thumb, index, middle finger and half of your ring finger. The discomfort can in some cases extend towards your elbow. The symptoms usually start during the nighttime and are felt when waking up with numb hands but can also progress to a constant annoyance.
Your symptoms are likely aggravated by activities that include a lot of gripping like reading the paper, driving or painting. Early on, your symptoms may be somewhat relieved by "shaking your hands out". You may sometimes feel as though your hands are getting tightened or that they are progressively swelling. In more severe cases, hand weakness can develop.
Compression of your median nerve in the carpal tunnel is usually found along with compression at a second or third site as well. Researchers call this "double crush syndrome." Common "double crush" partners for CTS often include the spine or muscles in your neck, shoulder and forearm.
To help improve your condition, you should do your best to avoid activities that involve repetitive wrist flexion, i.e. push ups. Holding the handlebars on your bicycle will likely cause irritation of your condition. Our office may prescribe a special splint that keeps your wrist in a neutral or slightly extended position that will help with your nighttime symptoms.
If CPS is left untreated, carpal tunnel syndrome can result in permanent nerve damage. The American Academy of Neurology recommends conservative treatment, like the type provided in our office, before considering surgical alternatives.