Carpal Tunnel Syndrome

Do you wake up with numbness and pins and needles sensation in your hand at night? If yes, you might have a condition known as Carpal Tunnel Syndrome, an extremely common condition in middle aged people.

Q. What is carpal tunnel syndrome?
A. A common condition that causes pain, tingling, numbness, and weakness in the hand and wrist.
Carpal Tunnel Syndrome as the name hints is a confined tube or canal in the wrist, allowing a nerve called as median nerve and tendons to connect the hand and forearm.
The parts of this tunnel include: Carpal or wrist bones which make up the bottom and sides of the tunnel & a ligament that holds the tunnel together. The Median nerve & tendons are inside the tunnel. This Median nerve adds strength to the base of the thumb and index finger and also provides sensation to most of the fingers in the hand.
So, if anything that compresses or irritates the median nerve, one can have carpal tunnel syndrome.

Q. What are the Causes & Risk factors for Carpal tunnel syndrome?

Many times, there is no single cause, it may be that a combination of risk factors contributing to the development of the condition.
These risk factors include anatomic factors like a wrist fracture or dislocation, or arthritis that deforms the small bones in the wrist which alters the space within the tunnel and put pressure on the median nerve.
Generally, carpal tunnel syndrome is more common in women, probably because the carpal tunnel area is relatively smaller in women than in men. It is also common during menopause or pregnancy.
Conditions – such as diabetes, thyroid issues increase risk of nerve damage directly. Indirectly, inflammatory conditions like Rheumatoid arthritis can affect the lining around the tendons and put pressure on the median nerve.

What are the symptoms of Carpal tunnel syndrome & how do you diagnose it?

The three main symptoms associated with CTS are Pain, Numbness and Tingling sensation in the thumb and the two fingers next to it, as well as half of the ring finger
Very commonly, the first symptoms often appear at night, or on getting up in the morning. Sometimes patient may feel the need “shake out” their hands when they wake up or the discomfort may wake them frequently during the night, but as the condition progresses, symptoms may persist throughout the day. Sometimes the person may lose grip strength and find it difficult to make a fist or grasp small objects.
For diagnosis the signs & symptoms and sometimes x-ray to rule out arthritis or trauma are needed. Also Electromyography and nerve conduction studies determines how well the median nerve itself is functioning and how well it controls muscle movement.

What are the treatment options available for Carpal tunnel syndrome?

Carpal tunnel syndrome can be treated in two ways: non-surgically or with surgery. Surgery is recommended only as a last resort when carpal tunnel syndrome does not respond to non-surgical treatments. 
Non-surgical treatment options are Wrist splinting, anti-inflammatory medications, image guided corticosteroid injections which may help improve carpal tunnel syndrome symptoms. One of the very newer & effective non-surgical treatment options is nerve hydro-dissection or neural prolotherapy and regenerative therapy called as PRP – platelet rich plasma, has shown extremely promising results without any side effects.
Platelet rich plasma therapy or simply called as PRP is a regenerative medicine technique that uses patients own blood to treat an injury. In this case it is injected surrounding the median nerve. And to inject it precisely, the help of ultrasound machine is taken to locate the nerve and to see the needle in real time. Because the platelet rich plasma comes from patient’s own body, the likelihood of rejection or allergic reaction is almost nil. Best of all, the procedure is pain free, effective and quick.

What precautions can be taken to help reduce Carpal tunnel syndrome symptoms?

  • .Minimize the repetitive wrist movements. Can wear a splint at night to keep wrist straight or in neutral while sleeping.
  • Alternate between activities to reduce the strain on hands or wrists.
  • Avoid holding an object the same way for longer time.
  • People with profession having desk job, adjust desk, chair, and keyboard so that forearms are level with work surface.




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