Carpal Tunnel Syndrome

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Carpal tunnel syndrome is a condition in which the median nerve gets compressed as it passes from the forearm into the hand via the carpal tunnel in the wrist.  The carpal tunnel is a rigid narrow passageway of ligaments and bones in the wrist.

If the median nerve gets thickened (due to inflammation), or if the carpal tunnel becomes narrowed due to swelling of the surrounding soft tissue, the median nerve can get compressed.  This is what causes Carpal Tunnel Syndrome.

The median nerve supplies sensation to the palm side of the thumb and fingers, as well as stimulus for movement of the small muscles of the hand, hence its compression results in painful and troubling symptoms of the affected hand.

What are the Symptoms of Carpal Tunnel Syndrome?

Symptoms of CTS usually start gradually and get progressively severe over time.  One or both hands may be affected and women are about three times more likely than men to develop this disorder.  As overuse predisposes one to developing the condition, it is the dominant hand which is more at risk of developing CTS.

• Burning, tingling or numbness in the hand, especially the thumb, index and middle fingers
• Feeling of swelling in the fingers (without any actual swelling)
• Clumsy in the hands, gradually having difficulty gripping things or performing other simple tasks
• Pain in the hand during sleep, causing one to wake up and feel the need to "shake out" the hand
• Severe loss of sensation may make it difficult to differentiate hot from cold

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome is usually the result of a combination of various factors that cause narrowing of the carpal tunnel.  It is likely that some people are born with narrower carpal tunnels, making them more likely to develop the syndrome.

Other factors which may increase the risk of developing CTS include:

• Previous injury to the wrist eg. previous fracture
• Rheumatoid arthritis
• Hypothyroidism
• Diabetes mellitus
• Overactivity of the pituitary gland
• Fluid retention during pregnancy
• Frequent use of vibrating hand tools
• Repetitive movement causing bursitis and tendinitis in the wrist region
• Certain occupations e.g. those who work in an assembly line (manufacturing, cleaning, packing, sewing etc)

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