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Carpal tunnel syndrome - symptoms, description and treatment

Author MUDr. Peter Bednarčík CSc.

Revision

1. Compressed nerve and numb part of the hand shown in grey 2. The median nerve 3. The transverse carpal ligament
1. Compressed nerve and numb part of the hand shown in grey 2. The median nerve 3. The transverse carpal ligament

Do you feel prickling and tingling in your palm and fingers? Does your hand hurt when you write or drive? These problems can be a sign of carpal tunnel syndrome.

It is a condition where a compressed nerve in the wrist causes uncomfortable sensations. They can worsen at night and limit you in your daily activities.[1]

Learn how to recognize the symptoms , the cause and what treatment options are available. How to suppress symptoms such as pain, swelling and inflammation that accompany this disease? Read more here.

Carpal tunnel syndrome symptoms

  • Prickling and tingling
  • Loss of sensitivity in the wrist
  • Numbness in the wrist
  • Weakness while using the hand
  • Wrist pain
  • Wrist swelling [2]

Symptoms usually appear gradually and the problems tend to worsen at night.

Notice

Only a physician can make a correct diagnosis. Do not use this or any other article on the internet to make a diagnosis. Do not delay seeing your physician and address your condition early.

Carpal tunnel syndrome description and causes

Risk factor for carpal tunnel syndrome - prolonged computer work
Risk factor for carpal tunnel syndrome - prolonged computer work

What is carpal tunnel syndrome?

It is a condition in which the nerve in the wrist is compressed in the carpal tunnel, leading to impaired function and a number of problems.  It causes pain, tingling, burning or prickling in the hands, usually in the thumb, index, middle and ring fingers. This problem often occurs in people who work with computers or repeatedly strain their hands and wrists.

The tarsal tunnel syndrome is similar to carpal tunnel syndrome, which affects the lower limb. Repeated pressure on the tibial nerve, located near the ankle, causes pain in the foot or directly in the ankle.

Causes of carpal tunnel syndrome

It is caused by pressure on the median nerve (nervus medianus). The 7 risk factors tell you who is most at risk of problems e and whether you are at risk yourself.

Carpal Tunnel Risk Factors

  • Wrist fracture
    If you have had a fracture or injury to your wrist in the past, this can lead to problems.
  • Certain diseases
    Rheumatoid arthritis or diabetes can lead to inflammation.
  • Repeated movements of the hand and wrist
    For example, when working on a keyboard, doing assembly work or using vibrating tools such as a drill. [3]
  • Being overweight or obese
    They can cause increased pressure on the nerves.
  • Hereditary predisposition
    Some people may have a smaller or narrower than others. Or you may have someone in your family who has also suffered from this syndrome.[4]

Women are three times more likely to suffer than men, so being a female is also a risk factor. [5]

Carpal Tunnel Syndrome in Pregnancy

These problems in pregnancy are related to fluid retention in the body during this period and swelling of the ligament of the wrist. Due to this, irritation of the median nerve occurs, and women have difficulties. After childbirth, the issue usually goes away on its own. Patients describe the situation as if the syndrome suddenly disappeared. [6]

Carpal Tunnel: Acute and Chronic

The acute form  is not very common. A sudden increase in carpal tunnel pressure is usually caused by an accident, burn or infection. On the other hand, the chronic form, i.e. the long-term duration of wrist problems, is much more common. Patients can have symptoms for months or years. [7]

Which Doctor Solves Disease – Diagnostics in a Nutshell

With problems that are typical of syndrome, you can visit a general practitioner, neurologist or orthopaedist. The treating doctor will be interested in an accurate description of the problems, when the pain occurs, what brings you relief and how long the problems last. [8]

  • Finger and wrist palpation
    It is important for the diagnosis. The doctor uses it to determine the sensitivity and strength of the hand.
  • Ultrasound scan
    The doctor gets an overview of the condition of the wrist from the inside.
  • X-ray examination
    It can help by detecting other diseases that may manifest similarly to the syndrome.
  • Electromyographic examination (EMG)
    It measures nerve conductivity and can not only confirm the diagnosis but also determine its severity.[9]

Carpal tunnel syndrome self-test - How to detect carpal tunnel problem?

Phalenův test
1 - area of numbness, 2 - Phalen's carpal tunnel test

Symptoms need to be properly investigated. Different examination methods are used for this. One of the basic guidelines is the Phalen’s test.

This consists of pressing the backs of your hands together, fingers pointing downwards and forearms parallel to the ground. Stay in this position for at least a minute. If you feel prickling, tingling or burning pain, you probably have problems.  [10]

Did you know ?

  • Up to 350 cases per 100,000 inhabitants are diagnosed each year.
  • Women are affected by this syndrome 3 times as much as men.
  • Average age of patients is 45-55. [11]

Complications When Left Untreated

If  is left untreated or treatment is not effective, symptoms can worsen and complications can occur.

  • Limitations in hand function of the ability to perform activities of daily living.
  • Pain can become chronic, which can affect quality of life.
  • Loss of sensitivity may be permanent.
  • It can lead to loss of muscle strength.
Limitation of hand function

Limitation of hand function

Chronic pain

Chronic pain

Loss of sensitivity

Loss of sensitivity

Loss of strength

Loss of strength

Notice

We recommend not delaying carpal tunnel treatment

Do not delay carpal tunnel syndrome treatment and see a specialist if you have any health problems or doubts about your condition. This will prevent unnecessary health complications.

Carpal tunnel syndrome treatment

Carpal tunnel syndrome brace
Carpal tunnel syndrome brace

Neglecting the problem and inadequate treatment can cause permanent damage to nerves and muscles. It is therefore worth starting treatment as soon as possible.

How do you treat it?

  • The first and simplest step in treatment is to limit activities that aggravate wrist problems.
  • Regular breaks and relaxation exercises are recommended for activities that strain the wrist.
  • A splint or brace is also a good help. It can also be worn at night, when pain tends to be worse than during the day.
  • Pain killers (non-steroidal anti-inflammatory drugs) can be used in the short term. Corticosteroids are also used to relieve pain, swelling and inflammation.
  • Another possible treatment is surgery. [12]
Notice

Beware

Treatment for carpal tunnel syndrome can only be determined by your physician after considering your overall health. Therefore, do not use this article as a guide to treatment, which can only be determined by a doctor.

Carpal tunnel ointment

Patients often ask in pharmacies and surgeries if there are any “home remedies” for carpal tunnel syndrome. Ointments – such as those containing menthol – can provide pain relief. [13] Another option is ointments with various herbal extracts applied to the wrist and hand. Either a doctor or a pharmacist can advise on their selection.

Dietary supplements

  • A proper diet can alleviate the symptoms.
  • Limit foods that promote inflammation. For example, foods high in sugar, meat products with high amounts of unhealthy fats, fried and salted foods).
  • Include fish, vegetables, nuts, fruits and herbs in your diet.
  • Dietary supplements containing vitamin B12, B6 and omega-3 fatty acids. [14]

Carpal tunnel surgery

After carpal tunnel surgery, patients have a wrist wound
After carpal tunnel surgery, patients have a wrist wound

Surgery is resorted to in situations where no other treatments help or when the symptoms are severe. The aim of the operation is to relieve pressure on the nerve in the wrist and relieve the patient of pain. [15]

The healing time after the surgery ranges from weeks to months. However, healing of the wound visible on the skin is faster and takes several weeks. When recovering from surgery, the hand should be used gradually and the wrist should not be exposed to extreme positions or heavy loads. [16]

How to deal with swelling after surgery?

Carpal tunnel surgery, like any other surgery, has certain risks. For example, there may be an infection or swelling at the site of surgery. Any complications in the healing process should be discussed with your doctor who will determine the most appropriate course of action. [17] In general, cold compresses, for example, help with swelling . [18]

Prevention and exercise in carpal tunnel syndrome

The principles of a prevention can be summarized in 5 points.

  • Take the power down. In many everyday activities, you unconsciously push on your wrist with great force without needing to. These include, for example, holding a computer mouse spastically, typing on a keyboard or holding a steering wheel.
  • Practice relaxation exercises. Repeat them throughout each day.
  • Make sure your whole body posture is correct. Problems are also affected by the position of the head, shoulders and cervical spine.
  • Wear gloves. Be sure to wear them when working in the cold.
  • Customize your work environment. Arrange your working environment so that it is comfortable and you don’t have to make unnatural movements with your hands. [19]

Carpal tunnel syndrome and exercise

Exercise can relieve you of unpleasant pain. Try 5 simple exercises that can be done even when you’re sitting at your desk or waiting for the bus.

  • Repeatedly clench and open your fist. Repeat the exercise several times.
  • Raise your arms above your head to allow for better blood flow. [20]
  • Gently bend your wrists up and down.
  • Place your palm on the table and place your other hand perpendicularly over the back of your hand. Lift the wrist and fingers of the bottom hand, applying downward pressure with the other hand.
  • Squeeze a small foam ball repeatedly in the palm of your hand[21]

Yoga also offers inspiration for further stretching exercises and training in correct upper body posture. Take advice from a qualified yoga teacher who will demonstrate the exercises so you can do them correctly. [22]

Notice

Important cautions when dealing with carpal tunnel

Don’t let problems get to the stage where you suffer severe pain.

Think about ergonomics at work and at home, i.e. the optimal size and layout of the work surface and all tools. A comfortable body position at work is also important.

Don’t overexert yourself.

The most common causee is overuse. Sometimes it is considered an occupational disease. In the Czech Republic, this syndrome accounts for a significant proportion of all occupational diseases.

Summary and recommendations for the management of carpal tunnel syndrome

1.

See your physician

Treatment for carpal tunnel syndrome is always determined by your doctor based on a general examination, an assessment of your condition, and an accurate diagnosis.

2.

Causal treatment of carpal tunnel syndrome

After a general examination, your doctor will recommend treatment for the cause of carpal tunnel syndrome. In connection with this, they will also recommend possible lifestyle modification and further management.

3.

Suppressing pain, swelling and promoting healing

Symptomatic treatment focuses on the manifestations or symptoms of the disease. Such treatment can significantly improve your quality of life and support comprehensive treatment as the disease progresses.

Sources, references and literature

1. Carpal Tunnel Syndrome. NHS, 16. February 2021. https://www.nhs.uk/conditions/carpal-tunnel-syndrome/

2. Carpal tunnel syndrome. Mayo Clinic, 25. February 2022. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603Overview

3. Carpal tunnel syndrome. Mayo Clinic, 25. February 2022. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603Overview

4. Wheeler T. et al. Carpal Tunnel Syndrome. WebMD, 19. November 2021. https://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome

5. Wheeler T. et al. Carpal Tunnel Syndrome. WebMD, 19. November 2021. https://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome

6. Carpal tunnel syndrome. Mayo Clinic, 25. February 2022. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603Overview

7. Aroori S., Spence R. A. Carpal tunnel syndrome. Ulster Med J. 2008; 77(1): 6-17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2397020/

8. Wheeler T. et al. Carpal Tunnel Syndrome. WebMD, 19. November 2021. https://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome

9. Carpal Tunnel Test. Eastern Suburbs Chiropractic. https://easternchiro.com.au/patient-info/could-chiropractic-help-you/carpal-tunnel-test/

10. Carpal Tunnel Test. Eastern Suburbs Chiropractic. https://easternchiro.com.au/patient-info/could-chiropractic-help-you/carpal-tunnel-test/

11. Minks E: et al. Professional carpal tunnel syndrome. Neurol. practice 2014; 15(5): 234-239. https://www.neurologiepropraxi.cz/pdfs/neu/2014/05/03.pdf

12. Carpal tunnel syndrome. Mayo Clinic, 25. February 2022. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603Overview

13. Marcin A. 9 Home Remedies for Carpal Tunnel Relief. Healthline, 7. March 2019. https://www.healthline.com/health/home-remedies-for-carpal-tunnel#-Home-remedies-for-carpal-tunnel

14. Whelan C. Foods to Eat or Avoid If You Have Carpal Tunnel Syndrome. Healthline, 22. December 2020. https://www.healthline.com/health/carpal-tunnel-foods-to-avoid#foods-to-avoid

15. Carpal tunnel syndrome. Mayo Clinic, 25. February 2022. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603Overview

16. Carpal tunnel syndrome. Mayo Clinic, 25. February 2022. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603Overview

17. Carpal Tunnel Release. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/carpal-tunnel-release

18. Carpal tunnel syndrome. Mayo Clinic, 25. February 2022. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603Overview

19. Wheeler T. et al. Carpal Tunnel Syndrome. WebMD, 19. November 2021. https://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome

20. Marcin A. 9 Home Remedies for Carpal Tunnel Relief. Healthline, 7. March 2019. https://www.healthline.com/health/home-remedies-for-carpal-tunnel#-Home-remedies-for-carpal-tunnel

21. Sissons B. 7 hand exercises for carpal tunnel syndrome with Picture. Medical News Today, 1. November 2021. https://www.medicalnewstoday.com/articles/hand-exercises-for-carpal-tunnel#exercises

[22] Carpal tunnel syndrome. Mayo Clinic, 25. February 2022. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603Overview

How to reduce pain, swelling and promote healing? Try 3D magnetic therapy
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