What is Carpal Tunnel Syndrome?

Overview of the condition

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is a common condition that affects the hand and wrist. It happens when the median nerve in the wrist is squeezed or compressed.

The median nerve passes through a narrow tunnel in the wrist called the carpal tunnel. When the tissues around this tunnel swell or become irritated, pressure builds on the nerve. This can cause numbness, tingling, pain, or weakness in the hand.

Why is it important?

If CTS is not treated early, it may lead to Permanent nerve damage in severe cases and can cause trouble doing daily activities.

Early diagnosis and treatment usually help prevent long-term problems.

Causes/Why it happens

Common causes and risk factors

Medical conditions

• Diabetes
• Thyroid problems
• Rheumatoid arthritis (joint inflammation)
• Obesity
• Pregnancy-related swelling

Repetitive hand activities

Repeated wrist movements can irritate the tendons and increase swelling. Examples include:

• Typing
• Sewing
• Using vibrating tools
• Repeated lifting or gripping

Wrist injury: A fracture or injury near the wrist can narrow the tunnel and press on the nerve.

Family history: Some people naturally have a smaller carpal tunnel, which can run in families.

Lifestyle contributions: Certain habits may worsen symptoms:

• Poor posture while typing
• Long hours using phones or computers
• Lack of breaks during repetitive work
• Smoking
• Poor control of diabetes

Signs and symptoms

Symptoms usually start slowly and may come and go at first.

Common symptoms

• Tingling or ‘pins and needles’ in the thumb, index, middle and ring fingers
• Numbness in the hand
• Pain in the wrist or hand
• Symptoms are worse at night
• Weak grip or dropping objects
• Feeling like the hand is swollen even when it looks normal

Some people shake their hands to get temporary relief.

Diagnosis and investigations

Doctors use a combination of physical examination and tests to confirm an injury.

• Clinical evaluation: Doctors usually diagnose CTS based on symptoms, medical history and physical examination of the hand and wrist
• Tests and investigations:
• Nerve conduction study/electromyogram (EMG): This is the most common test for CTS. Small electrical signals are used to see how well the nerve works. This helps confirm nerve compression and severity
• Ultrasound: Shows swelling of the nerve
• Blood tests: May be done to look for underlying conditions such as diabetes, thyroid disease and arthritis
• Imaging scans: X-rays or magnetic resonance imaging (MRI) scans are not usually needed unless another problem is suspected, such as a fracture or arthritis

Treatment options

Treatment depends on the severity of the symptoms.

Lifestyle changes and self-care

• Wrist rest and activity changes:
• Reduce repetitive hand movements
• Take frequent breaks
• Avoid bending the wrist for long periods
• Ergonomic improvements: Using proper wrist support while typing or working may help reduce strain.
• Hand and nerve exercises: Simple stretching and nerve-gliding exercises may improve symptoms.
• Weight control and medical condition management: Good control of diabetes, thyroid disease and weight can help reduce symptoms.

Non-surgical treatment

• Wrist splints: A wrist splint keeps the wrist straight, especially during sleep. This is often one of the first treatments recommended.
• Medicines
• Pain-relieving medicines: Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen may help reduce pain temporarily
• Steroid injections: A corticosteroid injection into the wrist may reduce swelling and relieve symptoms for some time.
• Surgery: Carpal tunnel release surgery is usually performed to relieve numbness and pain, especially if done before permanent nerve damage occurs.

Myths and Facts

Frequently Asked Questions (FAQs)