Diagnosis

CARPAL TUNNEL SYNDROME


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 Definition Carpal tunnel syndrome is a compression disorder of the median nerve at the wrist that results in pain, numbness and weakness of the hand.
Details The median nerve is one of the main nerves of the wrist and hand. It travels into the hand via a narrow canal known as the carpal tunnel. This tunnel contains not only the median nerve but also many of the tendons that control bending of the fingers (the flexor tendons).
Causes Carpal tunnel syndrome is mainly due to swelling and inflammation of the tendons within the canal. This inflammation puts pressure on the nerve and results in the symptoms of pain, numbness and weakness. Repetitive activities such as excessive computer use can cause the inflammation and therefore lead to carpal tunnel syndrome. The disorders is also associated with diabetes, pregnancy and trauma.
Diagnosis Carpal tunnel syndrome is characterized by numbness and tingling in the thumb, index finger and long finger. It is usually worse at night. Weakness of the hand, such as difficulty opening a jar or car door, may also be present. Pushing on the wrist or hyperflexing the wrist may reproduce the symptoms. The diagnosis of carpal tunnel syndrome is confirmed by a electrical conduction study of the median nerve.
Treatment Nonoperative: Most cases of carpal tunnel syndrome can be treated with rest from the aggravating activity, anti-inflammatory medication, and splinting. A cortisone injection may also be considered. Improving a person's work conditions, such as adjusting a keyboard or height of a chair, are other important components of nonoperative treatment.

Operative: If these measures fail, or if progressive weakness is present, surgery should be considered. The surgery involves releasing a tight band of tissue that forms the roof of the carpal tunnel. This surgery increases the room available for the median nerve and leads to a significant reduction of the symptoms.
Prevention

Work and activity modifications are essential components of carpal tunnel syndrome prevention. Some stretching programs may also help prevent the disorder.


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