In everyday life, do you experience pain in your wrist when you try to pick up objects such as teapots? When you try to hold a coffee cup, do you feel that your hand is not as strong as it used to be and you feel like dropping it? Do you experience hand numbness that wakes you up at night? All these disorders can be caused by carpal tunnel syndrome, which is common in the community and is known as nerve compression in the hand.
Symptoms of carpal tunnel syndrome are usually seen as pain in the wrist, numbness and tingling in the fingers. However, you should consult a doctor before the symptoms of a pinched nerve in the hand start to affect your activities and sleep patterns. When carpal tunnel syndrome is left untreated, numbness, numbness and weakness may occur in the hand due to permanent nerve and muscle damage.
Table of Contents
- What is Carpal Tunnel Syndrome?
- What Causes Carpal Tunnel Syndrome?
- What are the Symptoms of Carpal Tunnel Syndrome?
- How is Carpal Tunnel Syndrome Diagnosed?
- What are the Treatment Options for Carpal Tunnel Syndrome?
- Non-Surgical Treatment Options
- Carpal Tunnel Syndrome Surgery
- Carpal Tunnel Syndrome in Pregnancy
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is the medical name for what is commonly known as a pinched nerve in the hand. Our wrist has a narrow tunnel-like canal lined with bones on one side and connective tissue on the other. This channel is called the “carpal tunnel”. The nerve known as the median nerve, which passes through the carpal tunnel, controls the movement of the fingers of the hand and especially the sensation in the first three fingers. As a result of the narrowing of the carpal tunnel in a way that puts pressure on the median nerve passing through it; it causes complaints such as pain, numbness, tingling and weakness in the hand. The resulting picture is known as “Carpal Tunnel Syndrome“.
What Causes Carpal Tunnel Syndrome?
Although the cause of nerve compression in the hand is not known exactly, there are some conditions that cause it to occur. Especially advancing age and gender are risk factors for carpal tunnel syndrome. The carpal tunnel is relatively smaller in women than in men. Therefore, nerve compression in the hand is more common in women.
Some of the causes and risk factors for carpal tunnel syndrome are as follows:
- Diabetes (diabetes),
- Obesity (obesity),
- Wrist fractures,
- Rheumatic diseases such as rheumatoid arthritis,
- Hypothyroidism (underactive thyroid gland),
- Mass formation in the carpal tunnel,
- Repetitive hand-wrist movements at home, at work, in sports,
- Use of vibrating tools or machines at work.
What are the Symptoms of Carpal Tunnel Syndrome?
Symptoms of carpal tunnel syndrome usually appear gradually. The symptoms become more pronounced and progressively worse over time. Symptoms of a pinched nerve in the hand typically manifest as one or more of the following:
- Burning, tingling or numbness in the palm and especially in the thumb, index and middle finger,
- Hand and wrist pain, numbness or tingling sensation that wakes you from sleep at night, partially relieved by shaking your hand,
- Numbness and tingling when holding the wrist in a fixed position, such as when driving a car or reading a book,
- Pain radiating from the wrist up the arm,
- Difficulty holding or grasping objects due to weakness in the hands and fingers,
- Numbness and tingling sensations that occur with repetitive movements such as knitting or dyeing,
- In advanced cases of carpal tunnel syndrome, the appearance of collapse as a result of weakening of the muscle on the palm side of the thumb.
Symptoms of a pinched nerve in the hand have quite distinctive features. However, there are other neuropathies (nerve disorders) or degenerative conditions such as osteoarthritis of the hand that can cause similar symptoms. In order to determine the right steps in the treatment of carpal tunnel syndrome, an examination and evaluation by a doctor is necessary.
How is Carpal Tunnel Syndrome Diagnosed?
For the diagnosis of nerve compression in the hand (carpal tunnel syndrome), the patient’s complaints and history must first be learned. It is important to learn from the patient about the onset and duration of complaints, the conditions that increase complaints and other health problems, if any. The patient is then examined in detail.
To clarify the diagnosis, some tests specific to carpal tunnel syndrome are ordered. These tests check whether complaints are increasing. Motor and sensory examination is used to check for muscle weakness and sensory deficits in the hand. If physical examination supports the suspicion of carpal tunnel syndrome, electrophysiological tests are used to confirm the diagnosis. Electromyography, also known as EMG, is performed. This diagnostic method determines the degree of nerve compression in the carpal tunnel by measuring nerve conduction velocities and assessing muscle strength. Since some other nerve and muscle diseases can also be detected during EMG, it is a guide in differential diagnosis.
It is important to differentiate carpal tunnel syndrome from pain caused by a herniated disc in the neck, spine, shoulder or elbow. If the patient has complaints about these areas other than the wrist, it is useful to evaluate these areas with radiological imaging methods such as X-ray, magnetic resonance imaging (MRI), ultrasound in order to determine the actual source of the problem. In cases where carpal tunnel syndrome is caused by a rheumatic disease, diabetes or goiter, various blood tests are required.
What are the Treatment Options for Carpal Tunnel Syndrome?
There are various surgical and non-operative treatment options for the treatment of carpal tunnel syndrome to relieve pain in the hand and numbness in the fingers. Depending on your complaints and the degree of nerve compression, you will be followed up with the appropriate treatment. The aim of the treatment of carpal tunnel syndrome is to reduce and eliminate the conditions that cause compression and damage to the median nerve in the carpal tunnel.
Non-Surgical Treatment Options
Some of the non-surgical treatment methods in the treatment of carpal tunnel syndrome are as follows:
Rest: Taking a break from repetitive movements that strain the wrist for a while will alleviate the numbness and painful process.
Medication use: Various medications are used to reduce pain and pain caused by nerve compression. However, it is important to remember that medication does not eliminate the underlying problem. Medicines can be used on a short-term basis according to the doctor’s recommendation.
Using a wrist brace: A wrist splint (wrist brace) keeps the wrist in a natural position during movements in everyday life and while sleeping at night. The wrist and surrounding muscles, ligaments and joint are kept in the ideal position. Thus, there is less pressure on the tendons and nerve passing through the carpal tunnel and complaints are reduced. It may be recommended to use the bracelet for a few weeks during daytime activities and at night when going to bed.
Cold application: One of the methods used in the treatment of carpal tunnel syndrome is cold application. The cold helps to reduce swelling and relieve pain in the wrist. Cold application can be done 3-4 times a day for a period of 15-20 minutes. To avoid a rash-like reaction to cold on your skin, you should avoid direct contact of the ice with the skin. The cold pack can be applied by wrapping it with a thin towel or sheath.
Making changes in daily life: Although the complaints related to carpal tunnel syndrome can be controlled with various methods, the person may need to make some changes in their daily life or change their habits to prevent recurrence. Those who use vibrating tools such as drills should take breaks from work more often. It is recommended that office workers prefer to use ergonomic keyboards and supportive mousepads when using computers.
Injection treatment for carpal tunnel: In the treatment of carpal tunnel syndrome, when rest, use of wrist bracelets, cold application and medication do not respond, injection therapy is considered.
Physical therapy and exercise: Patients diagnosed with carpal tunnel syndrome are recommended a physical therapy and exercise program along with non-operative treatments. In addition, if necessary, a physiotherapy program is applied after the operation to increase the mobility of the nerve and enable the patient to use his/her hand comfortably.
Carpal Tunnel Syndrome Surgery
Not every patient needs carpal tunnel syndrome surgery. Carpal tunnel surgery becomes an option when non-surgical treatment options are not useful, when the complaints begin to recur in a short time and in advanced cases such as melting of the muscles around the thumb due to nerve compression.
In carpal tunnel syndrome surgery, an incision of approximately 3-4 centimeters is made on the inside of the wrist. Then, the connective tissue that forms the upper wall of the carpal tunnel is loosened, allowing free movement of the structures passing through the tunnel.
After this procedure, which is usually performed under local anesthesia, the patient goes home on the same day. Stitches are removed after 10-15 days. After the stitches are removed, massage is recommended to prevent stiffness at the wound site and an exercise program is recommended to regain the range of motion of the wrist.
Carpal Tunnel Syndrome in Pregnancy
In the later stages of pregnancy (usually from the 6th month onwards), the excess fluid (edema) accumulated in the body, which manifests itself as swelling in the hands and feet, creates pressure in the carpal tunnel in the wrist and compresses the structures passing through the tunnel. Compression of the median nerve in the carpal tunnel causes complaints such as numbness, tingling and pain in the hand and fingers.
As the edema in the body decreases after delivery, the pressure in the carpal tunnel will also decrease and the complaints usually disappear. Rarely, surgery may be required. It is recommended to rest, use wrist braces, apply cold, do appropriate exercises and stay away from movements that require bending the wrist, among the non-surgical methods we mentioned to reduce complaints in the period until birth. Carpal tunnel syndrome may occur due to many causes and may also cause different complaints. You can visit our center to make sure that your complaints are caused by carpal tunnel syndrome and to evaluate your treatment options. You can contact us, share your questions and comments and find answers about what you are curious about