Carpal Tunnel Syndrome: Symptoms, Diagnosis, Treatment

In the human hand, the carpal tunnel is a narrow passage that contains the median nerve and tendons that bend the fingers. Sensations from the hand are transmitted to the brain via the median nerve, and the brain then transmits impulses to the muscles.

In other words, the carpal tunnel helps communicate to the brain what the hand senses and causes the muscles of the hand to move. 

Carpal tunnel syndrome refers to a condition that causes pain, numbness, and tingling in your hands and fingers. This condition occurs when the median nerve is compressed and squeezed.

Carpal Tunnel Syndrome symptoms

• Numbness or tingling in the fingers, particularly the thumb, index, middle and ring fingers
• Numbness or pain that worsens at night and wakes you up from sleep
• Shock-like sensations that radiate to the thumb, index, middle and ring fingers
• Weakness in the hands - difficulty in holding and gripping items

Carpal Tunnel Syndrome risk factors

• Women are more likely to develop carpal tunnel syndrome than men.
• In some people, their carpal tunnel is naturally smaller, and this increases the risk of developing carpal tunnel syndrome.
• Those with family history of carpal tunnel syndrome may be at risk of developing carpal tunnel syndrome.
• Repetitive hand and wrist movements over an extended period could also cause pinching of the nerve.
• People with health conditions such as diabetes, rheumatoid arthritis, and thyroid gland imbalance are at a higher risk too.
• During pregnancy, some women may experience swelling that results in pressure on the nerve due to hormonal changes.

Carpal Tunnel Syndrome diagnosis

Your doctor would first question your general health and symptoms before conducting a thorough physical examination.

Diagnosis is made based on your reported symptoms, physical examination, and investigations.

• Electrophysiological tests such as nerve conduction studies (NCS) and electromyogram (EMG) can be used to evaluate if there is too much pressure on your median nerve. 
• X-rays provide images of dense structures like bones.
• High-frequency sound waves are used in an ultrasound to help create images of bone and tissue. An ultrasound of the wrist may be suggested to check for signs of median nerve compression.
• Magnetic Resonance Imaging (MRI) scans provide detailed images of the soft tissue.

Carpal Tunnel Syndrome treatment

If carpal tunnel syndrome is left untreated for an extended period, it can worsen and cause dysfunction of the hand, including loss of sensation in the fingers.

There are several surgical and non-surgical treatment options for carpal tunnel syndrome.

Non-surgical treatment options

• Wear a wrist splint at night to relieve pressure on the nerve by keeping hands in a neutral position.
• Avoid or minimise activities that require the flexing and extension of the hand and wrist for a prolonged time.
• Steroids is a powerful anti-inflammatory medication that can be injected into the carpal tunnel to calm a flare-up of symptoms or to relieve painful symptoms. 
• Hand exercises may be beneficial for some patients.

Surgical treatment options

Surgery may only be recommended if symptoms such as pain, numbness, and tingling sensation on a moderate to severe degree lasts six months or longer, or if other treatments have not improved your symptoms. 

• In the open carpal tunnel release surgery, a small incision is made in the wrist and the transverse carpal ligament is cut to ease the pressure on the median nerve.
• During the endoscopic carpal tunnel release surgery (minimally invasive carpal tunnel surgery),the surgeon makes a small incision in the wrist and inserts an endoscope (a camera attached to a narrow tube) to view the inside of your wrist. A special knife is then used to cut the transverse carpal ligament similar to the open carpal tunnel release.

In most instances, carpal tunnel surgery is performed as a day-care procedure, and you are not required to stay overnight at the hospital.

Carpal Tunnel Syndrome prevention

There are no specific methods to prevent carpal tunnel syndrome. However, you can minimise the risk by practising the techniques below: 

• Take frequent breaks. Occasionally, stretch and gently flex your wrists.
• Maintain good posture.
• Keep hands warm.
• Ensure the computer mouse does not strain your wrist.

Make an appointment at Gleneagles Hospitals

If you are experiencing any of the symptoms of Carpal Tunnel Syndrome, get in touch with us to find out more about our Orthopaedic Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with orthopaedic specialists to assist patients through diagnosis and treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.