Carpal Tunnel Syndrome

What is it?

Carpal tunnel syndrome occurs when the median nerve is compressed within the carpal tunnel at the wrist. The median nerve passes through this tunnel and into the thumb and the next three fingers.

Symptoms

• A dull ache in the wrist and forearm.
• Pain which radiates into the thumb and three fingers (excluding the little finger).
• Sensations of tingling or burning in the hand, thumb or three fingers.
• Pain which is worse at night.
• Pain may radiate into the forearm, elbow or shoulder.
• Weakness in the fingers and hands.

Causes

• Traumatic injuries at the wrist which cause swelling.
• Overuse injury of the wrist - causing inflammation and swelling.
• Pregnancy - due to water retention.
• Use of vibrating machinery.
• Arthritis.
• Congenital - some people naturally have a smaller, narrower carpal tunnel.

Who gets it?

Carpal tunnel syndrome is 3 times more common in women than men, probably because of the naturally smaller carpal tunnel. It is also common in diabetics.

How is it diagnosed?

Carpal tunnel syndrome is usually diagnosed by your Doctor after a history and examination of the problem. They may use the following tests to help: Tinels sign - Tapping with two fingers over the palm side of the wrist. The test is positive if any of the symptoms are reproduced. Phalens test - Place your hands in front of you at chest height with the fingers of the two hands touching. Flex the wrists so that you put the backs of your hands together. Hold this position for a minute. Reproduction of any symptoms is a positive result. Investigations may also be performed to confirm the diagnosis. You may be offered an MRI scan, ultrasound imaging, electromyography or a nerve conduction study.

Treatment

• Complete rest for the wrist - usually using a wrist splint.
• Cold therapy and anti-inflammatories may be used to ease inflammation and swelling.
• Stretching and strengthening exercises may be used once the wrist is painfree.
• Alternative therapist such as acupuncture may be useful.
• If this fails, a corticosteroid injection may be used.
• Surgery to release the carpal tunnel is a last resort but is reasonably common and effective.

What is the long-term prognosis?

The long-term prognosis is excellent. Most cases will clear up naturally with the use of a splint and alterations in causative activities.

External Links

http://www.sportsinjuryclinic.net/cybertherapist/front/wrist_forearm/carpal_tunnel_syndrome.htm

References

www.sportsinjuryclinic.net