Compression of the median nerve can occur when it passes through the carpal tunnel, a narrow space in the wrist that houses 9 tendons plus the median nerve- so let’s just say it’s a full house. These tendons attach to the muscles in the hand and control its movement. When there is compression of the nerve resulting in symptoms that manifest primarily in the hand, this is known as carpal tunnel syndrome. The median nerve is also called the laborer’s nerve. 

Quick Statistics

• More than 8 million Americans suffer from carpal tunnel syndrome annually, and ergonomic disorders are the fastest-growing category of work-related illness, accounting for 56% of all injuries. 
• Women are two to three times as likely as men to get carpal tunnel syndrome or CTS.
• 230,000 carpal tunnel surgeries are performed in the US each year, making it the second most common type of surgery.

Carpal Tunnel Syndrome Risk Factors

You might be at greater risk of developing carpal tunnel syndrome if you:

• Engage in repetitive, physical work that involves wrists and hands, such as assembly line work, sewing, cleaning, or meatpacking. 
• Have autoimmune disorders such as rheumatoid arthritis and hypothyroidism
• Are a woman 
• Have a smaller carpal tunnel than normal
• Are diabetic 
• Are pregnant 
• Are obese
• Suffer from alcoholism 

Causes of carpal tunnel syndrome or CTS 

There are several potential causes of the condition such as: 

• Trauma or injury to the wrist such as a sprain or fracture that causes swelling. Trauma most often causes some swelling, which puts pressure on the median nerve and leads to some symptoms in the hand and wrist.
• An overactive pituitary gland
• Autoimmune disorders such as hypothyroidism and rheumatoid arthritis
• Mechanical problems in the wrist joint
• Repetitive use of tools that vibrate
• Fluid retention during pregnancy or menopause
• A cyst or tumor in the tunnel 

What are the symptoms of carpal tunnel syndrome?

• Burning, tingling/ itching, numbness in your palm and thumb or your index and middle fingers
• Weakness in your hand and trouble holding things
• Increase in fluid retention
• Muscle atrophy at the thumb
• A loss of sensitivity to heat and cold

How does a person receive a diagnosis of carpal tunnel? 

• A physical exam 
• Lab tests and imaging, such as X-rays and ultrasound
• Nerve conduction study such as an EMG

Treatment of a carpal tunnel

Conservative treatment is available for CTS. An elevated pillow and a cold pack can be used together as conservative treatments. Cold packs can be applied for 15 to 20 minutes at a time to reduce swelling. Symptoms can also be reduced with over-the-counter or prescription medications and rest from aggravating activities. The wrist can also be supported by a splint during the day or at night, while you are performing some of these aggravating activities. 

Carpal tunnel syndrome can also be treated with alternative therapies such as acupuncture or chiropractic care. There is no evidence to support the effectiveness of such therapies; however, some people find that they are beneficial.  CTS can be treated with yoga as an alternative therapy which reduces pain and improves grip strength. 

Alternatively, if the case is severe, perhaps the person will benefit from surgery. The two types of carpal tunnel release are endoscopic release and open release. Studies show that patients who undergo open release have better results, as they tend not to have as many revisions to the surgery. The success rate of open release surgery is about 90%. Some people may still need therapy after that due to muscle wasting and atrophy. The palm of the hand will also be scarred, so scar management will be needed. 

Carpal Tunnel Syndrome Prevention

To avoid carpal tunnel syndrome, try to:

1. Use an ergonomic mouse pad and a keyboard wrist pad to support your wrist.
2. Avoid strong gripping of objects with your wrist flexed. As you work and move about your day, try to keep your wrists in a neutral position. 
3. Make sure your wrists are straight when using tools and try to limit the use of vibrating tools.
4. Take frequent breaks if you are regularly performing repetitive tasks, such as typing.
5. Perform wrist stretches. 
6. Maintain proper monitoring and treatment of conditions that can lead to carpal tunnel syndrome.

CTS and the associated symptoms can be an absolute nuisance. Prevention is always better than cure, so be sure to take care of your wrists so CTS doesn’t haunt you in the future.

Disclaimer: The above blog is not to be taken as medical advice. If you are experiencing symptoms, please seek out a physician or other qualified health care professional.