Learn more about carpal tunnel syndrome

Carpal tunnel syndrome is possibly the most common form of entrapment neuropathy due to the compression of the median nerve as it travels through the carpal tunnel. It can affect both the wrist and the hand. This condition is characterized by numbness, tingling, and pain in the thumb and first three fingers, and is associated with repeated hand and wrist movements during work, sports, or hobbies. It is more prevalent among females and usually occurs between the ages of 30 and 60.

An overview of carpal tunnel syndrome symptoms

• It may not be evident in the early stages that someone has carpal tunnel syndrome since its symptoms are not felt when the hands are being used. Instead, they appear during sleep, when the hand is at rest.
• In the early stages, people with carpal tunnel syndrome may experience numbness in their hands throughout the night, pain, and a tingling sensation in the fingers. Shaking the hands may provide relief from the symptoms.
• Their day-to-day symptoms are tingling and reduced sensations in the fingers, difficulty performing small tasks with their hands, such as holding small objects, holding a phone, gripping a steering wheel when driving, and many more.
• It is common for carpal tunnel syndrome to worsen with weak fingers and wrists, dropping objects due to weakness, numbness, or loss of awareness, and difficulties performing everyday tasks such as buttoning shirts.

Factors causing carpal tunnel syndrome

• It is believed that repetitive finger use and certain motions are associated with the development of carpal tunnel syndrome. These include hammering, prolonged wrist movements, and using vibrating tools.
• Additionally, hormone fluctuations during pregnancy or menopause, gender, as women tend to have smaller carpal tunnels, diabetes, bone or joint diseases like osteoarthritis or rheumatoid arthritis, a family history of the smaller area of the carpal tunnel, injuries to the wrists, such as fractures, sprains, strains, dislocations, and swelling, and obesity all play an imperative role.

How to diagnose carpal tunnel syndrome?

• As part of a physical examination, the doctor primarily reviews the pattern of symptoms and examines the entire upper limb, which includes the neck, shoulders, elbows, and wrists, to exclude other causes. An initial examination of the hand and wrist may offer some clues to the cause. During the examination, the patient is assessed for sensation to pain, two-point discrimination, soft tissue over the median nerve, and mechanical restrictions.
• A Tinel’s sign is when it causes pain to radiate from the wrist to the hand when tapped over the affected nerve.
• Phalen tests are conducted by bending the wrist forward while resting the elbows on the table for a few seconds. If numbness, tingling, or weakness are felt, it is positive for carpal tunnel syndrome.
• In addition to X-rays, nerve tests are used to determine whether the median nerve is functioning properly and to rule out other conditions such as arthritis.

Managing and treating carpal tunnel syndrome

• A simple treatment for carpal tunnel syndrome is to rest the hands by taking frequent breaks, to avoid activities that worsen symptoms, and to apply cold packs to reduce swelling in the early stages.
• A combination of non-surgical modalities is recommended for mild to moderate carpal tunnel syndrome, such as a wrist splint to prevent wrist movement at night, thus reducing nerve compression in the carpal tunnel and relieving symptoms such as tingling and numbness during the night.
• A variety of medications are prescribed for these conditions, including NSAIDS, , vitamin B6 etc:
• Patients with severe median nerve damage, characterized by sensory or motor loss, axonal loss or denervation, or an electrodiagnostic study indicating that the median nerve has been damaged, are treated with surgery. The two most effective types of surgeries are open carpal tunnel release and endoscopic

The use of physical therapy for the treatment of Carpal Tunnel Syndrome.

• It can be beneficial to modify activities and workplaces in order to control milder symptoms of CTS. For example, placing the hand on the keyboard at a proper height, and minimizing any flexion, extension, abduction, and adduction of the hand while typing are examples of such modifications.
• With the use of ultrasound therapy, adhesions will be broken, circulation will be increased, and  the range of motion will improve. Ultrasound has fibrinolytic, anti-inflammatory, and anti-irritant properties.
• An effective way to reduce pain and swelling is through transcutaneous electrical stimulation.
• Physiotherapists advise patients to take sufficient rest and immobilize their affected hands. Splinting and hand braces help eliminate active movements in the affected hand. The wrist is fixed in a neutral position so that tensions in the carpal canal are minimal, and the interphalangeal and carpometacarpal joints are fixed in slight flexion in order to achieve the same result.
• A stretching exercise such as “Stretch Armstrong” involves positioning the arms in front, spreading the fingers one at a time, and then extending the wrist and fingers as far as possible and holding for 20 seconds, in which the fingers point up to the ceiling while bending the hand towards the body.
•  Exercises that strengthen the hands, such as Squeezing a rubber ball in the center of your palm, help strengthen your grip. Repeat the exercise 5 times, 3-5 times per week, to strengthen your grip, and this activity of squeezing the ball may be beneficial for improving muscle strength.

Conclusion

In light of the modern lifestyle characterized by sedentary habits and extensive computer use, it is particularly necessary to recognize the early signs of carpal tunnel syndrome. Once symptoms appear, it is imperative to consult a doctor as soon as possible to avoid further progression and worsening of the condition. A few lifestyle modifications can help, particularly for people who have a higher risk of developing carpal tunnel syndrome due to their everyday activities. In order to avoid aggravated pain, it is important to take frequent rest breaks, stretch, change positions, maintain proper posture, and maintain proper wrist position.