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Carpal Tunnel Syndrome

Pain, Numbness, and Tingling in the Hand Due to Pressure on the Median Nerve

An estimated one in twenty adults develops hand pain, numbness, and tingling after a wrist trauma, repetitive motions, or an inflammatory illness. This condition is known as carpal tunnel syndrome. It starts when the median nerve, an important nerve that provides grip strength and feeling in the hand, is irritated. Pain specialists diagnose and treat carpal tunnel syndrome so you can be pain free and recover the full use of your hand.

What is the carpal tunnel?

The carpal tunnel is a small area in the wrist, enclosed by eight small bones and the transverse ligament, a strong band that stabilizes the wrist.

Inside the carpal tunnel is the median nerve, an important nerve that runs from the forearm to the hand. The median nerve controls hand muscles and provides feeling in all the fingers except for the pinky.

Inside the carpal tunnel, the median nerve is surrounded by nine tendons. If there is any inflammation in these tendons or other wrist tissues, it puts pressure on the median nerve, leading to hand numbness, tingling, pain, and weakness. These symptoms are known as carpal tunnel syndrome.

Symptoms of carpal tunnel syndrome

Carpal Tunnel Syndrome develops slowly over time. Symptoms usually appear in the dominant hand if a person uses it for repetitive tasks.Symptoms can appear in both hands if a person uses them for repetitive motions like drill work or typing.

Symptoms in the hand(s):

  • Burning
  • Tingling
  • Numbness
  • Loss of sensation
  • Feeling swollen (without having visible swelling)
  • Burning and tingling that travels up the arm
  • Reduced grip strength

Risks factors for carpal tunnel syndrome

Some people, especially women, are born with a narrow carpal tunnel and are more likely to experience pressure on the median nerve.

Illnesses such as rheumatoid or psoriatic arthritis cause inflammation in the wrist tendons and increase pressure on the median nerve.

Water retention in the wrist occurs with obesity, pregnancy, and hypothyroid disease. This can put pressure on the median nerve from outside the carpal tunnel.

Other risk factors:

  • Wrist injuries (sprain, fracture)
  • Repetitive hand motions (playing a musical instrument)
  • Manual labor
  • Use of vibrating hand tools
  • Diabetes (damages the median nerve)

Diagnosis - when to see a doctor

You should see a doctor, such as a pain specialist, within the first couple of weeks after you start having pain and tingling in your hand(s). People who ignore these symptoms for too long may suffer permanent damage to the median nerve or require surgery.

Your pain specialist will conduct the following tests:

Phalen test - you flex (bend backward) the wrist
Tinel test - you press the backs of your hands against each other

(hand numbness, tingling, or pain during these tests are signs of carpal tunnel syndrome)

You may need:

Treatments for carpal tunnel syndrome

Initially, symptoms may improve with:

  • Rest
  • Wrist Splints
  • Anti-inflammatories
  • Ultrasound therapy
  • Physical and occupational therapy

The following treatments are offered by pain specialists for carpal tunnel syndrome:

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