Carpal Tunnel Syndrome

Carpal tunnel syndrome is a painful progressive condition affecting 4-10 million Americans. It is the most common nerve disorder experienced today. The main symptoms of carpal tunnel syndrome are numbness, tingling, and weakness in the fingers. The numbness is caused by compression of a key nerve in the wrist, the median nerve. The median nerve runs from the forearm into the palm of the hand and passes through a narrow, rigid passageway of ligament and bones at the base of the hand (NIH). This area of the wrist is called the carpal tunnel, thickening from irritated tendons and swelling here causes compression on the median nerve resulting in carpal tunnel syndrome. The increase pressure on the median nerve can result from a combination of

The neck, shoulders, arms, wrists, and hands are examined for feeling, strength, and appearance (WebMd). Each finger should be treated for sensation, and the muscles at the base of the hand should be examined for strength and signs of atrophy. The Tinel and Phalen tests are specific tests used to produce the symptoms of carpal tunnel syndrome. In the Tinel test, the doctor taps on or pressed on the median nerve in the patient’s wrist. If tingling in the fingers or a resultant shock-like sensation occurs, the test is positive (NIH). Another test is the Phalen, or wrist-flexion, the test involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the back of the hands together (NIH). The test is positive for signs of carpal tunnel syndrome if one or more symptoms, such as tingling or increasing numbness, are felt in the fingers in less than 1 minute. The doctor may also ask the patient to make a movement that brings on

The goal of treatment is to allow the patient to return to normal function and activities along with prevention of nerve damage and loss of muscle strength in fingers and hand. If the patient presents with diabetes and arthritis, it is important to treat those diagnosis first. Initial treatment generally involves resting the affected hand and wrist for at least two weeks, avoiding activities that may cause symptoms to worsen. Patient is also recommended to immobilize the wrist by wearing a wrist splint to avoid further damage from twisting or bending. If the symptoms are mild, 1 to 2 weeks of home treatment are likely to relieve the symptoms (WebMd). Physical therapy such as ultrasound, stretching, strengthening, and range-of-motion exercises can be helpful in people whose symptoms have become less intense but still exist. In some cases, medicine can ease the pain and swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and other nonprescription pain relievers can relieve pain and reduce inflammation. Corticosteroids by mouth or corticosteroid injections may relieve pressure on the median nerve and provide immediate, temporary relief to persons with mild or intermittent symptoms. Patients with diabetes or who are predisposed to diabetes should not use corticosteroids for a prolonged period of time because it can make it difficult to regulate insulin levels. Vitamin B16