Carpal Tunnel Syndrome – Median Nerve Entrapment

Carpal tunnel syndrome occurs when there is pressure on the median nerve. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the wrist. The median nerve provides sensory and motor movements to the thumb along with middle and index fingers. If it gets compressed, the patient tends to notice symptoms related to it like tingling, numbness, and weakness in holding objects.

Symptoms of Carpal tunnel syndrome  

The symptoms associated with carpal tunnel syndrome show up gradually and include-

Tingling or Numbness- You may feel a ‘pins and needles or electric shock like sensation or numbness in your hands and fingers, especially, thumb, middle and index fingers. It usually occurs while driving, holding a phone or newspaper. Sometimes it is so strong that will wake you up from the sleep.  

Weakness- The patients suffering from Carpal tunnel syndrome may feel weakness in their hands and drops objects often. This occurs due to weakness in the thumb muscles which are controlled by the median nerve.   

If you have these symptoms, consult a Peripheral nerve surgeon for further evaluation and treatment. 

Causes of the Carpal tunnel syndrome  

There can be many causes leading to the condition of Carpal tunnel syndrome and some of them are mentioned below-

Risk factors of the Carpal tunnel syndrome

Anatomic factors

These include wrist fracture, dislocation, or arthritis that leads to bone deformation in the wrist and alters the space within the carpal tunnel leading to pressure on the median nerve. 

Sex 

Due to the relatively small carpal tunnel area, this condition usually occurs in women

Nerve-damaging conditions 

Some chronic diseases like diabetes increase nerve damage which results in damage to the median nerve. 

Inflammatory conditions 

Rheumatoid arthritis and other conditions affect the wrist jointsg and the surrounding tendons and thus put pressure on the median nerve. 

Obesity 

Someone who is obese has a higher risk of suffering from Carpal tunnel syndrome.  

Body Fluids 

Fluid retention will lead to pressure on the Carpal tunnel irritating the median nerve. Most common during pregnancy and menopause.  

Other medical conditions 

Certain conditions like thyroid imbalance, acromegaly, kidney failure, and lymphedema increase the chances of Carpal tunnel syndrome. 

Diagnosis and Treatment of Carpal tunnel syndrome

Initially, the diagnosis is made by electrodiagnostic tests done by stimulating the muscles and nerves in your hand to examine the nerve functionality. Typically, there will be slow conduction of the current in the nerve when it is stimulated above the wrist.  

The Carpal tunnel syndrome treatment may include-   

During open surgery, the surgeon cut open your wrist, and the tissue pressing the nerves is cut open which relieves the pressure on the nerve.   

During endoscopic surgery, the surgeon put a long, thin endoscope through a tiny cut on the wrist. The rod contains a camera and torch which helps the surgeon to examine the wrist. After the surgery, your wrist and hand will be wrapped with a splint which restricts the movement of the wrist and hand to facilitate the recovery. 

If you are advised to undergo a carpal tunnel release surgery, then get a second opinion from an experienced surgeon for carpal tunnel syndrome to explore all the treatment options. 

Dr. Arun Rajeswaran

Consult Dr. Arun with a professional experience of more than 13 years in the field of Neurosurgery

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