 Carpal
Tunnel Syndrome
What is Carpal Tunnel
Syndrome (CTS)?
The carpal tunnel is a small
tunnel made of bones and ligaments in the wrist. The median nerve runs
down the forearm through the tunnel and into the hand on the palm side
of the hand and provides feeling to the hand and fingers. The median nerve
can become compromised from inflammation under this tunnel, which leads
to carpal tunnel syndrome. The carpal tunnel does not allow for movement
or growth of the nerve. Therefore, when it inflames, the median nerve
is constricted and does not allow blood to flow through the hand to the
fingers.
What Causes CTS?
CTS can be a result of many different
things. It can be due to work, lifestyle, health, injuries, and even genetic
predisposition. The most common cause of CTS is repetitive motion. Certain
conditions like diabetes, pregnancy, and obesity can predispose somebody
to CTS. Common symptoms include numbness and pain in the hand. This
is typically worse at night and can awaken one from sleep. It is typically
relieved by shaking the hand. Other symptoms can be the tendency to drop
things, difficulty manipulating small objects, and a burning sensation.
With progression of the carpal tunnel syndrome there can be decreased
sensation in the hand, muscle atrophy in the palm, and decreased hand
strength and function.
How is CTS Diagnosed?
CTS can be diagnosed in a variety
of ways. Physical examinations can show evidence of CTS. A Tinel's test
might be used by your physician. The physician will gently tap on
the front of the wrist, which may cause tingling or pain in the hand.
A Phalen's test can also be used. The physician will bend your wrist
fully forward and then hold it in that position for a period of time.
This may produce tingling or numbness in the fingers. Physicians use nerve
conduction studies (NCSs) and needle EMG to diagnose CTS. Nerve conduction
studies measure electrical impulse speeds traveling through the nerve.
An electrical stimulation will be sent down the nerve from various points
in your upper arm and forearm. The time it takes for that electrical message
to reach a point in the hand is then carefully measured by the physician.
The physician will determine whether the nerves in the upper arm and forearm
are carrying the message normally and whether if he message gets to the
wrist and is slowed down or reduced in intensity. If a person has CTS,
the speed of the impulse will decrease as it passes through the carpal
tunnel. An EMG can also help diagnose CTS. Blood tests may be performed
to rule out other conditions.
How is CTS Treated?
There can be several ways to
treat CTS. Treatment can include stretching exercises, immobilizing the
wrist, anti-inflammatory drugs, vitamin B6, cortisone injections, ice,
modifying activities, and the extreme, surgery. Surgery for CTS is successful
95% of the time. The best way to avoid recurrence is to modify the behaviors
that caused the CTS.
To Find a Specialist
To find a physician board-certified
to conduct needle EMG and nerve conduction studies click here: www.abemexam.org
For More Information
American Chronic Pain Association:
www.theacpa.org
MedicineNet.com: www.focusonarthritis.com
National Institute of Neurological
Disorders and Stroke: www.ninds.nih.gov
E-Hand.com: www.eatonhand.com
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