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Carpal tunnel syndrome


Disease: Carpal tunnel syndrome Carpal tunnel syndrome
Category: Neurological diseases

Disease Definition:

Carpal tunnel syndrome actually has numerous causes, although it might seem that it is a condition born from long hours spent working on a computer keyboard.


Located on the palm side of the wrist, the carpal tunnel is a narrow passageway about as big around as one's thumb and it is bound by bones and ligaments. The main nerve to the hand and nine tendons that bend the fingers are protected by this tunnel. Pain, numbness and, eventually hand weakness that characterize carpal tunnel syndrome are caused by pressure placed on the nerve.


The good thing is that the pain and numbness can be relieved and normal use of the wrists and hands can be restored for most people who develop carpal tunnel syndrome.

Work Group:

Symptoms, Causes


With a vague aching in the wrist that can extend to the hand or forearm, carpal tunnel syndrome usually starts gradually. Here are some other common carpal tunnel syndrome symptoms:


  • A sense of weakness in the hand and a tendency to drop objects.
  • Tingling or numbness in the hand or fingers, especially the thumb and index, middle or ring fingers, but not the little finger. While holding newspaper, phone or a steering wheel or upon awakening is when this sensation often occurs. To try to relieve the symptoms, many people "shake out" their hands. The numb feeling may become constant as the disorder progresses.
  • Pain radiating or extending from the wrist up the arm to the shoulder or down into the palm or fingers, after forceful or repetitive use in particular. This usually occurs on the palm side of the forearm.


A person should see a doctor when having persistent signs and symptoms that might be due to carpal tunnel syndrome and that interfere with his/her normal activities, including sleep. Muscle and nerve damage can occur when the condition is left without treatment.


Pressure on the median nerve is the cause of carpal tunnel syndrome. The median nerve has a sensory function and it also provides nerve signals to move the muscles (motor function), so it is a mixed nerve. Sensation to the middle-finger side of the ring finger, middle finger, index finger and thumb are provided by the median nerve.


Anything that reduces the space for the nerve in the carpal tunnel can cause pressure on this nerve. Here are the possible causes:

Repetitive use or injury:

The pressure within the carpal tunnel can increase because of repetitive flexing and extending of the tendons in the hands and wrists, when done forcefully and for prolonged periods without rest in particular. Swelling that exerts pressure on the median nerve can be caused by injury to the wrist.

Physical characteristics:

It might be that one's carpal tunnel is more narrow than average.

Other health conditions:

Certain hormonal disorders such as diabetes, menopause and thyroid disorders; deposits of amyloid which is an abnormal protein produced by cells in the bone marrow; fluid retention due to pregnancy (after childbirth, carpal tunnel syndrome that is associated with pregnancy almost always improves); or rheumatoid arthritis are some examples of these health conditions.


Some research has suggested that overuse or strain in certain job tasks that require combination of forceful, awkward or stressed, and repetitive motion of the hands and wrists, may cause carpal tunnel syndrome. Using power tools such as jackhammers, chain saws, chippers or grinders; and heavy assembly line work such as occurs in a meatpacking plant, are included in the examples. The scientific evidence for this association isn't definitive although repetitive computer use is commonly assumed to cause carpal tunnel syndrome. A person may be at higher risk of developing the condition if his/her hobbies or work are hand-intensive involving a combination of awkward, repetitive wrist or finger motions, forceful pinching or gripping, and working with vibrating tools; however it is not clear which activities can cause carpal tunnel syndrome.


The following are other risk factors for this disease:

Certain health conditions:

People with end-stage kidney disease are more likely to develop carpal tunnel syndrome.


Women are three times more likely than men to develop carpal tunnel syndrome.


If someone’s close relatives have had carpal tunnel syndrome, he/she may be significantly more likely to develop the condition. One may become more susceptible because of inherited physical characteristics, such as the shape of the wrist.





By taking more frequent breaks to rest the hands and applying cold packs to reduce occasional swelling, some people with mild symptoms of carpal tunnel syndrome can ease their discomfort. Medications, wrist splinting and surgery are included in carpal tunnel syndrome treatment options, in case the techniques mentioned above don't offer relief.



Nonsurgical methods offer effective treatment for most people with carpal tunnel syndrome; these methods include:


To relieve the pain, the carpal tunnel of the patient may be injected with a corticosteroid, such as cortisone. Pressure on the median nerve can be relieved as corticosteroids decrease inflammation. For treating carpal tunnel syndrome, oral corticosteroids aren't as effective as corticosteroid injections.

Wrist splinting:

Nighttime symptoms of tingling and numbness can be relieved by a splint that holds the wrist still while the person sleeps. If the patient has had only mild to moderate symptoms for less than 10 months, splinting and other conservative treatments are more likely to help.

Nonsteroidal anti-inflammatory drugs (NSAIDs):

If the person has an associated inflammatory condition, NSAIDs may help relieve pain from carpal tunnel syndrome.


Treating the underlying condition generally reduces the carpal tunnel syndrome symptoms as well if carpal tunnel syndrome results from an inflammatory arthritis, such as rheumatoid arthritis.



If a person has only mild nerve impairment, nonsurgical treatments may be more effective in general. However, surgery may be the best option when the numbness or pain of carpal tunnel syndrome persists more than six months.


One of a few accepted techniques may be used. However, the ligament pressing on the nerve of the patient is cut in all accepted surgical procedures. In some cases, making a larger incision in the palm of the patient's hand over the carpal tunnel and releasing the nerve are involved in the surgery. And from time to time, surgery can be done by using an endoscope, which is a telescope-like device with a tiny camera attached to it that allows the doctor to see inside the carpal tunnel of the patient and perform the surgery through small incisions in his/her hand or wrist. 


The patient may experience some residual numbness, stiffness, weakness or pain, though marked improvement is usually the result of surgery. About 70% of the people who have undergone carpal tunnel release are completely or very satisfied with the outcome of their surgery. Exposure to repetitive, forceful activity, smoking, lower mental and physical health status before surgery, and drinking more than two alcoholic drinks a day are included in some variables that are associated with lower levels of satisfaction.


It may take from several weeks to as long as a few months for soreness or weakness to resolve. The patient should talk with the surgeon about the procedure that will work best for him/her and with his/her plans to return to the previous activity levels, both at home and at work, if surgery appears to be the best alternative for preventing further muscle degeneration or relieving the patient's symptoms.  


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