Carpal Tunnel Syndrome

What is it Carpal Tunnel Syndrome?

Is a condition where the median nerve is compressed as it passes through the small bony tunnel made by the carpal bones of the wrist. It can cause tingling, numbness or discomfort in the hand, often worse at night. It may cause clumsiness of the hand in carrying out fine movements. It is a common cause of discomfort in the hand, especially in middle age, more common in females (5:1 ratio) and usually occurs in the dominant hand.



What causes Carpal Tunnel Syndrome?

Although direct compression on the carpal tunnel from ganglions, fractures or dislocations is possible, the cause is usually due to prolonged wrist use in either full extension or full flexion as in these positions pressure inside the tunnel increases. Fluid retention is also a common cause of Carpel tunnel syndrome, which makes this more common in pregnancy and other conditions such as rheumatoid arthritis, diabetes or connective tissue disorders.

How is Carpal Tunnel Syndrome evaluated?

Different physical examination tests on the wrist and nerves are used to elevate the carpal tunnel. Also electromyography (nerve testing) may be used test the nerve and muscles

What is the treatment for Carpal Tunnel Syndrome?

Initial treatment may involve supporting the wrist in a resting splint (sometimes only needed at night). Ergonomic advice will be given in regards to the hand and wrist position or the use of keyboards.

Examination and therapy for any mechanical problems of the wrist, cervical spine or thoracic outlet. The vitamin B complex may be recommended. Chiropractic adjustment of the lunate (in the wrist) may be helpful.

When non responsive to any of the above a hydrocortisone injection or surgical release of the retinaculum may be necessary.