Dr. Srivatsa Subramanya, Orthopaedic surgeon, Vasavi Hospital, Bangalore, India, explains about carpel tunnel syndrome and how it can be treated. Carpel tunnel syndrome is a condition affecting the wrist. It is quite a common condition marked by pain and tingling sensation in the fingers and palm. Initially, the pain might be overlooked by an individual, but if ignored it may become worse with time. Carpel tunnel syndrome is more common in the elderly population, but it can affect anyone.
Let us first understand the structure of the wrist and what exactly a carpel tunnel syndrome is?
A human wrist has a tunnel-like structure comprising of the wrist bones and the connective tissue. The roof of the tunnel is made up of a thick band of tissue known as transverse carpel ligament. The forearm tendons pass through the tunnel from the forearm to the hands, and they help in bending of fingers and thumb. A layer of thin tissue surrounds these tendons, known as synovial sheets. Another important structure that passes through the tunnel is the median nerve, responsible for the sensation on the palm side of the thumb, the index finger and the middle finger.
In the Carpel Tunnel Syndrome, the tissues around the tendons swell up, decreasing the space in the tunnel, which in turn puts pressure on the nerves.
Causes of tissue swelling in the wrist region can be:
- Pregnancy-related swelling
- Thyroid hormone changes
- Rheumatoid arthritis
More than one of these factors can cause Carpel Tunnel Syndrome.
Carpel tunnel syndrome symptoms are:
- Tingling and numbness in your hands
- Strange, painful sensation spreading from the arms to the shoulder
- Fatigue while doing activities such as driving or talking on the phone
- Difficulty in holding a book while reading or difficulty in washing utensils
- Weakness of some muscles of the fingers or the thumb
Symptoms may occur anytime during the day but are usually more noticeable in the night, when one may curl up their hands and sleep. This is due to the pressure on the nerves. Initially, symptoms are intermittent but can become constant later on.
When experiencing any of the above-mentioned symptoms, one should not ignore the pain. It is advisable to consult an experienced orthopaedic surgeon. Your doctor will perform a thorough examination of the nerves, through assessment of sensation in the hands and the muscles around your thumbs. If required, he may perform an electro diagnostics test to confirm the diagnosis of Carpel Tunnel Syndrome.
Carpel Tunnel Syndrome treatment usually starts with non-operative management. Your doctor may advise some pain medication and suggest wearing a splint to ease away the pressure on the nerve and relieve you of the pain. Sometimes he may prescribe injections in the affected wrist.
In severe cases, a patient may not respond to any of these treatment modalities. The doctor might advise you to undergo a Carpel Tunnel Syndrome release. It is a surgery performed to release the pressure on the nerves. An individual can return to daily life activities within a few weeks post surgery.