Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a disorder caused by pressure on the median nerve in the narrow area of ​​the wrist called the carpal tunnel. The carpal tunnel is a passage on the palm side of the hand, limited by bones and ligaments.

This syndrome manifests itself with symptoms such as numbness, burning and weakness felt in the hands and arms as a result of pressure on the median nerve. It is a condition that often occurs as a result of excessive use of hands.

Factors such as the person’s wrist structure, other existing health conditions and constant use of the same hand movements are effective in the development of carpal tunnel syndrome. Effective medical treatments can reduce symptoms such as numbness and burning and help patients return their hand and wrist functions to normal.

What Causes Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a disorder that occurs in the hand and wrist and is characterized by compression and pressure on the median nerve. The median nerve runs along the arm and passes through a narrow passage formed by some bones and ligaments of the wrist, called the carpal tunnel, providing sensation to most of the hand. This nerve controls the palm side of the other fingers of the hand, except the little finger, and carries the nerve signals that enable the thumb to move.

The factors that cause carpal tunnel syndrome are diverse, and often there is a combination of more than one factor.

Anatomical reasons are among the main causes of this syndrome. Conditions such as fractures, dislocations or rheumatoid arthritis in the wrist can disrupt the structure of the carpal tunnel and put pressure on the median nerve. Additionally, congenital small carpal tunnel structure may also increase the risk; This condition is especially common in women because women’s carpal tunnels tend to be narrower than men’s.

Chronic diseases that can cause nerve damage may increase the risk of carpal tunnel syndrome. Conditions such as diabetes can cause nerve damage, leading to this syndrome. Additionally, inflammatory diseases such as rheumatoid arthritis can affect the tissues around the wrist tendons, placing direct pressure on the median nerve. Other health conditions, such as thyroid problems, kidney failure, and lymphedema, may also increase the risk of developing this syndrome.

Obesity can increase risk by narrowing the carpal tunnel space. Conditions such as pregnancy and menopause can increase pressure on the median nerve by causing fluid retention in the body, but pregnancy-related carpal tunnel syndrome is usually temporary.

Work environment and activities can also contribute to carpal tunnel syndrome. Factors such as prolonged or repetitive wrist movements and the use of vibrating tools can damage the median nerve. However, there is evidence that these factors are not the sole cause of the syndrome. Opinions differ regarding the direct effect of computer use on carpal tunnel syndrome; Some research shows that this use may lead to other types of hand pain.

How to Prevent Carpal Tunnel Syndrome?

Although a completely effective solution for preventing Carpal Tunnel Syndrome has not yet been developed, some preventive measures can be taken that can help reduce the risk. These include methods that can be applied to minimize stress on the hands and wrists.

It is important to take care to use the hands and wrists without undue strain. In daily tasks and especially when working with the keyboard or other instruments, light and comfortable movements should be made and excessive force should be avoided. For example, when using the keyboard, soft touches should be made on the keys, and pens with a comfortable grip and thick tip should be preferred when writing.

Taking regular breaks in your work routine and gently stretching the hands and wrists during these breaks can help reduce tension. Performing different tasks intermittently, especially in jobs involving monotonous movements, balances the pressure on the joints.

Excessive flexion (inward bending) or extension (outward bending) movements of the wrist should be avoided. Ideally, the wrists should be kept in a neutral or slightly relaxed position. When using a computer, the keyboard and mouse should be set just below wrist level.

When using a mouse, a position in which the wrist can move comfortably should be preferred and unnecessary strain should be avoided. Also, proper posture is very important. Improper posture can increase tension in the neck, shoulders and wrists and indirectly increase the risk of carpal tunnel syndrome.

Cold weather conditions can trigger stiffness and pain in the hands. Therefore, it is important to keep hands and arms warm. If the environmental temperature is low, fingered or fingerless gloves can be used to keep wrists and hands warm. These measures may be effective in reducing the risk of carpal tunnel syndrome.

What are the symptoms of Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a disorder caused by compression of the median nerve in the hand and wrist and manifests itself with various signs and symptoms. These symptoms usually develop over time and gradually become severe. Some of the most common symptoms include:

Numbness and Tingling in the Fingers: The most common symptoms are numbness and tingling in the thumb, index, middle and ring fingers. The little finger is usually not affected. These sensations can sometimes be accompanied by electric shock-like sensations.

Pain in the Hand and Arm: Disturbing sensations often radiate from the hand to the wrist and arm. These pains may become more noticeable during actions such as holding things tightly, such as holding a phone or driving a car.

Symptoms That Exacerbate at Night: In many people, symptoms may be especially severe at night and may wake them up from sleep. Numbness and pain may continue throughout the night and may be felt in the morning.

Weakness in Hands: Weakness in hands and impaired hand-eye coordination may occur. This is especially evident in tasks requiring fine motor movements.

Difficulty in Holding Objects: Due to weakness and numbness in the hands, there may be difficulty in holding everyday objects. This may become especially evident when doing fine work or trying to grasp small objects.

Risk of Permanent Nerve Damage: If left untreated for a long time, carpal tunnel syndrome can lead to permanent nerve damage and serious loss of hand functions.

These symptoms can affect daily life and lead to more serious problems over time. If any of these symptoms are experienced, early intervention and correct treatment are important. Therefore, it is important to consult a healthcare professional when symptoms are noticed.

How is Carpal Tunnel Syndrome Diagnosed?

Diagnosis of carpal tunnel syndrome involves a comprehensive process that evaluates the patient’s complaints and symptoms. First, the doctor questions the patient’s medical history and details of his symptoms. At this stage, the time of onset of symptoms, their severity, and their relationship with daily activities are important. The doctor asks questions to understand the distribution and character of the symptoms. For example, the absence of involvement of the little finger highlights the role of the median nerve and helps distinguish other possible conditions.

During the physical examination, the doctor evaluates the feeling in the patient’s hand and the strength of the hand and fingers. It also performs simple tests, such as the Tinel test, to check whether symptoms are triggered by a light touch or pressure.

Sometimes, additional tests may be necessary to distinguish carpal tunnel syndrome from other hand and wrist conditions. For example, an x-ray of the wrist may be used to rule out other conditions, such as a fracture or arthritis.

Electromyography (EMG) testing helps detect nerve damage by measuring the electrical activity of muscles. During this test, a very thin needle electrode is inserted into specific muscles and the electrical activity of the muscle at rest and during contraction is recorded. EMG is used to determine the extent of nerve damage and to rule out other neurological disorders.

Nerve conduction study measures the conduction velocity of the median nerve. In this test, mild electrical impulses are sent to the nerve through electrodes attached to the skin. If nerve conduction velocity is lower than normal, this may be a sign of carpal tunnel syndrome.

These diagnostic methods allow the doctor to accurately diagnose carpal tunnel syndrome and rule out other possible health problems. If carpal tunnel syndrome is suspected, it is important to have these tests done. In this way, it may be possible to diagnose the disease at an early stage and create an appropriate treatment plan.

How is Carpal Tunnel Syndrome Treated?

Carpal tunnel syndrome, when detected at an early stage, can often be effectively treated with non-surgical methods. The treatment process is determined according to the severity of the symptoms and the patient’s general health condition.

Early Stage Treatment:

Rest and Activity Change: When symptoms first appear, it is important to avoid activities that strain the hand and wrist and take regular breaks. Additionally, paying attention to hand and wrist positions during daily activities may relieve symptoms.
Use of Wrist Splint: Wrist splint helps reduce the pressure on the median nerve by keeping the wrist in a fixed position during sleep at night or during daytime activities. Use, especially at night, can reduce numbness and tingling sensations.
Cold Compress: Applying a cold compress can be effective to reduce swelling and pain.

Medication:

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): These medications may provide short-term relief, but evidence is limited on their long-term effects.
Corticosteroid Injections: Corticosteroids can relieve symptoms by reducing swelling and inflammation. These injections are usually considered for more severe cases.

Surgical treatment:

Endoscopic Surgery: This minimally invasive method is performed with the help of a small camera and generally has a faster recovery time.
Open Surgery: In this traditional method, a larger incision is made in the palm of the hand and the ligament pressing on the median nerve is cut.
After surgery, patients can usually return to normal activities within a few weeks, although full recovery may take up to several months. Physical therapy and regular exercise after surgery can speed up the healing process and help regain full hand functions.

During the treatment process, especially after surgery, some patients may experience problems such as pain, weakness or permanent nerve damage. In these cases, additional treatment and support may be necessary.