Carpal tunnel syndrome

Overview

Carpal tunnel syndrome results from pressure on the median nerve located in the wrist. This nerve is connected to the hand and forearm through a narrow canal surrounded by bones and ligaments on the palm side of the hand. People with carpal tunnel syndrome experience pain, numbness, and weakness in the wrist and hand.

The anatomy of the wrist, certain health issues, and repetitive hand movements can all contribute to carpal tunnel syndrome. This condition occurs when the median nerve is compressed due to the narrowness of the canal and the surrounding tissues. As a result, the nerve is unable to function properly, leading to discomfort and impaired hand and wrist function.

Proper treatment is crucial in relieving the symptoms of carpal tunnel syndrome. Treatment options may include rest, splinting, medication, physical therapy, and in severe cases, surgery. With appropriate treatment, patients can alleviate tingling and numbness and restore proper hand and wrist function.

Symptoms

The following list of signs and symptoms of carpal tunnel syndrome includes:

• Tingling or numbness. Tingling and numbness in the fingers or hand, accompanied by an electric shock-like sensation, are common symptoms of a condition that typically affects the thumb and index, middle, or ring fingers but not the little finger. Activities such as holding a steering wheel, phone, or newspaper may trigger the symptoms, which can also occur during sleep. Many people try to alleviate the discomfort by shaking out their hands. However, if left untreated, the numbness may persist and become constant.
• Weakness. Weakness in the hand leading to dropping objects can occur as a result of numbness in the hand or weakness of the pinching muscles of the thumb, which are controlled by the median nerve.

If the symptoms and signs of carpal tunnel syndrome disrupt your regular activities or sleep habits, it is advisable to consult a medical professional. Without therapy, permanent nerve and muscle damage can occur.

Causes

Carpal tunnel syndrome occurs due to the compression of the median nerve, which runs from the forearm through the wrist’s carpal tunnel to provide sensation and motor function to the thumb and fingers’ base muscles, excluding the little finger. The pressure on this nerve can result from various factors, such as wrist fractures, inflammation caused by rheumatoid arthritis, or any other condition that narrows the carpal tunnel space. Usually, carpal tunnel syndrome is not caused by a single factor but a combination of risk factors, leading to its development. These risk factors can include genetic predisposition, repetitive hand and wrist movements, hormonal changes, obesity, and certain medical conditions. Identifying the underlying cause and managing the associated risk factors can help prevent and treat carpal tunnel syndrome effectively.

Risk factors

Carpal tunnel syndrome has been linked to a number of variables. Although they may not be the direct cause of carpal tunnel syndrome, they may make the median nerve more susceptible to irritation or damage. These include:

• Anatomic factors. Carpal tunnel syndrome may result from a wrist fracture or dislocation, or arthritis that deforms the small wrist bones, leading to a decrease in the carpal tunnel space and increased pressure on the median nerve. Furthermore, individuals with smaller carpal tunnels have a higher risk of developing this syndrome since the limited space makes the median nerve more susceptible to compression or irritation.
• Gender. In general, women are more likely to develop carpal tunnel syndrome. This may be due to the fact that women’s carpal tunnel syndrome is less severe than men’s. In comparison to women without the illness, women with carpal tunnel syndrome may have smaller carpal tunnels.
• Nerve-damaging conditions. The risk of nerve damage, particularly damage to the median nerve, is increased by a number of chronic conditions, including diabetes.
• Inflammatory conditions. The lining around the tendons in the wrist can be impacted by rheumatoid arthritis and other inflammatory diseases, placing pressure on the median nerve.
• Medications.  The use of anastrozole (Arimidex), a medication commonly prescribed for breast cancer treatment, has been associated with carpal tunnel syndrome in several studies.
• Obesity. Obesity increases the likelihood of developing carpal tunnel syndrome.
• Body fluid changes. The median nerve may become irritated if fluid retention raises the pressure inside the carpal tunnel. This frequently occurs during menopause and pregnancy. Pregnancy-related carpal tunnel syndrome typically gets better on its own after giving birth.
• Other medical conditions. Carpal tunnel syndrome may be more likely in those who have menopause, thyroid issues, kidney failure, lymphedema, and other medical concerns.
• Workplace factors.  Repetitive use of vibrating tools or working on an assembly line that requires constant wrist flexing may potentially cause harm to the median nerve, and the risk may be exacerbated in cold environments. However, there is conflicting scientific evidence, and these factors have not been conclusively established as direct causes of carpal tunnel syndrome.(2)