CARPAL TUNNEL SYNDROME Painful condition of the hand

Carpal tunnel syndrome is a medical condition that occurs when the median nerve of the wrist is compressed as it travels through the wrist at the carpal tunnel – the space in the wrist that is surrounded by wrist bones and a rigid ligament that links the bones together.

CTS tends to affect the thumb and the fingers particularly the index finger, the middle finger and radial half of the ring finger. The small finger is rarely affected.

Symptoms of CTS
The most common symptoms of CTS are numbness, tingling or burning sensations in thumb and fingers. The forearm and the upper arm can also experience aching or discomfort.

The pain is usually felt at night. Other less common symptoms are pain in the wrist or hands, loss of grip strength and being unable to make coordinated hand and finger movements to grasp and manipulate objects.

Weakness and wasting away of the thumb muscles usually happen when the condition remains untreated. The condition usually begins in adulthood and affects more women than men.

Causes of CTS
The cause of most cases of CTS is unknown. However, it can also be caused by any condition that causes pressure to the median nerve at the wrist.

Other conditions that can lead to CTS include obesity, pregnancy (due to hormonal changes) and rheumatoid arthritis.

There are also occupational factors that contribute to carpel tunnel syndrome including repetitive hand motions, awkward hand positions, strong gripping, mechanical stress on the palm and vibration.

Examples of people whose work-related tasks can contribute to the condition are cashiers, hairdressers, knitters or sewers, bakers who flex or extend the wrist while kneading dough, painters who use a spray paint gun and farmers milking cows or hand weeding.

People who use vibrating hand tools excessively may suffer from the condition as well. Some studies also show a possible link between people who type using a keyboard and carpal tunnel syndrome although there is no consistent evidence to support this.

Psychological factors such as stress can also contribute to the development of the condition according to some researchers.

Diagnosis and treatment
People who suspect they may have a problem with their hand or fingers should consult a doctor as soon as the symptoms appear.

The doctor will then evaluate the occupational or non-occupational risk factors then perform one of three tests that are used to detect the damage to the median nerve.

When the symptoms are mild or less likely to be permanent, the treatment includes anti-inflammatory drugs, cold packs, a wrist splint and rest.

Specific exercises and physical or occupational therapy may also be recommended. Health professionals recommend wearing the splint at night and while carrying out the activity that causes stress on the wrist.

Treatment can be spread over a period of one year in some instances. In severe cases, surgery is required if the above treatment does not offer relief. However, surgery should only be used as a last resort as the condition can recur even after surgery.

Prevention
In the case of non-occupational factors, very minimal prevention can be done. With occupational factors, however, redesigning of workstations and methods is important to minimise the stressful effects of repetitive motions through a rotation of tasks, work-rest schedules and work breaks to avoid putting the wrist under pressure through repetitive patterns of work.