The eight bones of the wrist form a U-shaped channel that houses several tendons and the Median nerve. This channel is called the Carpal tunnel. The median nerve handles sensation on the palm side of the first 3 ½ fingers. Compression or irritation of this nerve as it travels through the carpal tunnel causes the condition known as “Carpal tunnel syndrome”.
Carpal tunnel syndrome is the most common nerve entrapment, affecting 3-5% of the general population. It affects females two or three times more frequently than males. Carpal tunnel syndrome most often affects adults aged 45-60.
Carpal tunnel syndrome can be brought on by prolonged wrist flexion and/or repetitive wrist movements like supermarket scanning, keyboard use, carpentry or assembly line work. Exposure to vibration or cold may also aggravate the condition. Carpal tunnel syndrome is more common in your dominant hand but frequently affects both hands. Some risk factors for developing carpal tunnel syndrome include diabetes, thyroid disease, rheumatoid arthritis, alcoholism, kidney disease, and being short or overweight. Fluid retention during pregnancy is a common cause of carpal tunnel symptoms.
Symptoms of carpal tunnel syndrome include numbness, tingling, or discomfort on the palm side of your thumb, index, middle finger, and half of your ring finger. The discomfort can sometimes extend towards your elbow. The symptoms usually begin as nighttime discomfort or waking up with numb hands, but can progress to a constant annoyance. Your symptoms are likely aggravated by gripping activities like reading the paper, driving, or painting. Early on, your symptoms may be relieved by “shaking your hands out”. You may sometimes feel as though your hands are tight or swollen. In more severe cases, hand weakness can develop.
Compression of your median nerve in the carpal tunnel is often accompanied by compression at a second or third site as well. Researchers call this “double crush syndrome.” Common “double crush” partners for carpal tunnel syndrome involve the spine or muscles in your neck, shoulder, and forearm.
If left untreated, carpal tunnel syndrome can cause permanent nerve damage. The American Academy of Neurology recommends conservative treatment, like the type provided in our office, before considering surgical alternatives.
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