Carpel tunnel syndrome can cause pain and other issues, let’s look at the symptoms of carpal tunnel syndrome and what is the best method for carpal tunnel pain relief. If you have the symptoms of carpal tunnel syndrome for some time please Click Here to read how one person with carpal tunnel syndrome managed to get rid of the numbness, tingling and pain with no side effects!
What is Carpal Tunnel Syndrome?
Believe it or not Carpal Tunnel Syndrome affects a lot of people, for example in America more than 230,000 surgeries are performed each year in the USA, it is quite common. Some of the symptoms are pain and numbness, you may also have a tingling sensation in your hand or arm. CTS occurs when the median nerve (a major nerve going to the hand) is squashed or compacted along the way to your wrist.
Unfortunately, carpal tunnel syndrome worsens as time goes on, it is important to get an early diagnosis so that a course of treatment can be prescribed for you. In the early stages of CTS, the symptoms may be relieved by avoiding activities where that hand is used or by wearing a wrist splint.
The pressure on the median nerve eventually leads to damage to the nerve and other symptoms, to prevent this happening a surgical operation will be performed to take the pressure off the median nerve in some patients.
Where is the Carpel tunnel located?
The carpal tunnel is in the wrist, it is about 25 mm wide (1 inch) the base and walls are made from tiny wrist bones known as carpal bones. The transverse carpal ligament is the roof of the carpal tunnel and is formed from connective tissues which are quite stiff with little scope to expand or get bigger. The median nerve originates in the neck as part of a group of nerve roots, these roots join and form one individual nerve in the arm.
The median is the major nerve in the hand it passes up through the arm and the forearm, it functions by providing feeling in your thumb, index finger middle and ring finger. it also has control of the muscles at the base of your thumb. There are 9 tendons called flexor muscles that travel through the carpal tunnel.
Why does carpal tunnel syndrome happen?
Carpal tunnel syndrome happens because of pressure being put on the median nerve following a narrowing of the carpal tunnel. It may also happen when the synovium tissues that surround the flexor tendons begin to swell meaning less space for the median nerve. This extra pressure on the median nerve produces pain, tingling, numbness and feebleness in the hand.
Causes of carpal tunnel
This condition can be attributed to several factors, women and elderly people are more prone to developing carpal tunnel syndrome however there are other risk factors that include:
- People that constantly use their hands in the same way each day may irritate the tendons in the wrist bringing about swelling and putting pressure on the median nerve.
- Health conditions like rheumatoid arthritis, diabetes, over active thyroid gland is linked to CPS
- Genetics: The condition does run in families because of reduced carpal tunnel space in the wrist
- Pregnancy: Changes in hormone levels during a pregnancy may lead to swelling
Symptoms of carpal tunnel syndrome
- Numbness, a tingling sensation (like pins and needles) pain and burning normally in your thumb, index, middle or ring finger
- Intermittent shock sensation or feeling that beams out to your thumb, index, middle & ring finger
- Clumsy or weak feeling in your hand making it hard to do even the simplest of tasks
- The hand may feel numb or weak, so you may be unable to hold on to things and drop them
In nearly all cases symptoms of CTS start off slowly, there may be no sort of injury, the symptoms may come and go in the beginning but as it gets worsens the symptoms may happen more often and may last for much longer. People with CTS may be woken up at night because of sleeping with the wrist in a bent position leading to pain, sometimes relief can be found by shaking the hand.
If you have carpal tunnel symptoms you will need to visit your doctor for a physical examination and questions on your family history and your overall general health. The physical examination will involve the doctor pressing down or tapping on the median nerve to determine if you have any tingling or numbness, a test for sensitivity in your fingertips and hands will be done using a special instrument, your doctor will also check for any weakness in the muscles surrounding the base near your thumb. The muscles will be checked for any wastage.
Electrophysiological testing of the sensory & motor fibres of the trapped median nerve will allow an objective assessment of the carpal tunnel syndrome impairment.
Sometimes used to take a picture of the bone and tissue
An X-Ray will produce an image of the dense bone structure, it may also show other symptoms such as arthritis, fracture or a ligament injury.
Magnetic reasonance imaging
This is a type of scan that produces a better image of the soft tissues surrounding the median nerve
Carpal tunnel treatment
Even though CTS is a progressive condition and most people find that it worsens over a period it is essential to get an early diagnosis so that a treatment can be started.
Treatment without surgery
Depending on the diagnosis, if your symptoms are mild non-surgical treatment will be the first option, by wearing a wrist splint or brace may reduce the pressure on the nerve and relieve the symptoms.
NSAIDs (non-steroidal) anti-inflammatory drugs can help to relieve inflammation and pain for a period. A powerful cortisone injection may be injected into the carpal tunnel to relieve the inflammation however this will only reduce the symptoms for a limited period.
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Carpal tunnel Surgery
After a period has passed and the non-surgical treatments aren’t working at relieving the symptoms your doctor may propose surgery. This surgery is known as “carpal tunnel release” it is done to relieve the pressure around the median nerve. However, this decision will depend on how severe your symptoms are, in other words how much numbness and pain you are feeling in your hand and how long you have had these symptoms. The issue of muscle wastage comes into play in this decision to prevent more permanent damage.
This surgery is usually done under a general anesthetic on an outpatient basis, the doctor will make a slit in the middle of the hand to get a better view of the hands and wrist area. The aim of the surgery is to make the carpal tunnel area bigger so that there is less pressure on the nerve. The other method used is called endoscopic carpal tunnel syndrome release whereby a tiny camera is inserted through a small incision in the skin to get a better look at the hand and wrist area, a distinctive type of knife is used to separate the diagonal carpal ligament
Following the Carpal tunnel surgery, you will be advised to keep your hand elevated above your heart move the fingers to help with the swelling and to prevent stiffness. There will be swelling pain and stiffness following the procedure which may last for a few weeks. Depending on the condition of the median nerve pre-op it could take up to 12 months before your touch, grip and strength returns to your fingers and wrist.
Depending on how you feel after the procedure you may be allowed to do light activities around the house and workplace, you will have to wear a wrist brace or splint for a number of weeks, you may be allowed to drive and do light lifting, you may or may not be allowed to return to work.
Carpal tunnel release surgery complications
It is possible to have complications following any kind of surgery, however your doctor will try to minimize these risks:
- Median nerve injury or irritation
Most people that have had the procedure find that symptoms will improve, however complete recovery may take as long as 12 months. If you still have a lot of pain and weakness after the first two months, you may be referred to a hand therapist who may be able to help with the symptoms. If for example you have another condition such as arthritis or tendonitis it may take longer to recover particularly if there is atrophy (muscle wastage) present around the thumb area, for people like this it may not be possible to have a complete recovery. In rare cases carpal tunnel syndrome reoccurs, in which case additional treatment will be needed.