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Do I Have Carpal Tunnel Syndrome?

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a hand and arm condition caused when the median nerve (the main nerve that runs from your forearm into the palm of your hand) is pinched or squeezed at the wrist. The carpal tunnel is a narrow passageway in your wrist that protects the median nerve and nine tendons that bend your fingers. If the tendons running through the tunnel become irritated and swollen, the median nerve may be compressed. The result of this compression may be pain, numbness, and weakness in the hand and wrist that radiates up the arm. The median nerve controls movement and feeling in your thumb and first three fingers (not your little finger).

What Are the Symptoms of Carpal Tunnel Syndrome?

Symptoms often first show up at night, sufferers of Carpal Tunnel Syndrome may wake up feeling a need to "shake out" their hand or wrist. The syndrome starts gradually with an aching in your wrist. As symptoms worsen, you will notice tingling throughout the day. Common symptoms of Carpal Tunnel Syndrome include:

  • Numbness and tingling in the fingers and hand (thumb and first three fingers only, not the little finger). This often occurs when trying to grip or grasp simple items (steering wheel, phone, coffee cup, etc).
  • Pain that radiates from your wrist up your arm. This is most noticeable after repetitive or forceful use of the hand or arm.
  • Weakness in your hands and decreased grip strength may cause an inability to grasp objects or instances of dropping objects.

What Causes Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is the result of compression of the median nerve. This pressure may be due to one of many factors, including:

  • Congenital defect (born with a smaller carpal tunnel)
  • Trauma or injury that causes swelling of the wrist or bone spurs
  • Arthritis, thyroid disease or diabetes
  • Fluid retention during pregnancy or menopause
  • Repetitive use of the hands at work, especially the use of vibrating hand tools

There is no conclusive data that shows that prolonged computer work attributes to the condition. There are several other repetitive motion conditions that may be exacerbated by repetitive motion (tendonitis, bursitis, writer's cramp), however according to a Mayo Clinic study in 2001 heavy computer use does not increase the risk of developing Carpal Tunnel Syndrome (Science Daily, June 12, 2001).

How is carpal tunnel syndrome diagnosed?

In order to avoid permanent nerve damage, it is important to get a physical exam for early diagnosis. Your medical provider can rule out other disorders during a physical exam and help pinpoint the correct diagnosis. There are several exam components your medical provider may consider, here are some of the most common diagnostic tools used:

  • Identifying patterns of signs and symptoms (timing and circumstances when symptoms are most noticeable).
  • Physical exam of wrist for tenderness, swelling, etc.
  • Tinel and Phalen tests. These are simple tests that involve applying pressure to the median nerve (Tinel) and a wrist flexion test (Phalen) used to try to produce the symptoms of Carpal Tunnel Syndrome.
  • Electromyogram (EMG): a fine needle electrode is inserted into the muscle and the electrical activity is viewed on a screen. This test can help determine if muscle damage has occurred.
  • Nerve Conduction Study: Electrodes are placed on the hand and a small shock is passed through the median nerve to see if the nerve impulse is slowed in the carpal tunnel.
  • X-ray/MRI: May be used to rule out other causes of wrist pain.

How is it treated?

When diagnosed early, mild carpal tunnel symptoms may often be treated non-surgically. Common non-surgical treatments include rest, wrist splinting, non-steroidal anti-inflammatory drugs (NSAIDs), or corticosteroids (prednisone, cortisone injections). The sooner you start treatment, the better your chances of slowing symptoms and preventing long-term damage to the nerve and/or surgical intervention.
If after a course of non-surgical treatment symptoms persist or worsen, surgery may be the best option. Carpal tunnel surgery involves cutting the ligament to reduce the pressure on the median nerve. This allows more room for the nerve and alleviates symptoms. Soreness and weakness may take several weeks to completely go away, but further surgical intervention is seldom required after a successful procedure.

Can I Prevent Carpal Tunnel Syndrome?

There is no proven way to eliminate the possibility of getting Carpal Tunnel Syndrome, but you can diminish your chances by following a few easy guidelines:

  • Take periodic rest breaks while at work.
  • Improve your work posturing, use ergonomic tools to maintain natural wrist positions while at work.
  • Reduce force and relax your grip strength whenever possible.
  • Rotate job tasks periodically throughout the day
  • Keep your hands warm.
  • Follow your doctor's recommendations for any other long term health conditions.

As in all disease prevention, it is important to take care of your basic health needs. Stay at a healthy weight and exercise to remain strong and flexible. Consult your primary care provider if you feel you may have signs or symptoms of Carpal Tunnel Syndrome.