Carpal tunnel syndrome is caused by a compressed nerve in the wrist that causes symptoms in the hand. Pressure on the median nerve, which is inside a narrow passage in the wrist called the carpal tunnel, causes the nerve to malfunction. This nerve provides feeling to the thumb, index and middle fingers, and half the ring finger. It also controls several muscles in the hand, including the muscle that allows the thumb to touch the little finger. Compression occurs when the tissues in the carpal tunnel swell up.
Do you have carpal tunnel syndrome? Please call our Joint and Spine Center Navigator at (615) 781-5870 to make an appointment with one of our specialists.
Carpal tunnel syndrome is a repetitive strain injury. Although there are many causes for carpal tunnel syndrome, by far the most common is doing repetitive motions as part of your job. Many experts believe that the increased incidence of carpal tunnel syndrome is due to changes in workplace responsibilities in which one person commonly does a single task over and over again. There are approximately one million new cases every year.
Carpal Tunnel Symptoms
Carpal tunnel syndrome causes symptoms in one or both hands that, more rarely, may also extend up the arm. Symptoms are caused by compression of the median nerve in the carpal tunnel. This nerve supplies feeling to the thumb, index, middle, and half the ring finger. It also innervates the muscles that move the thumb toward the little finger and move the index finger around in a circle.
- Tingling, burning, or numbness, especially in your thumb and index or middle fingers
- Pain or numbness that worsens with:
- Wrist, hand, or finger movement
- Sleep (symptoms may wake you)
- Hand stiffness or cramping that gets better after:
- Shaking the hand
- Waking up in the morning
- Weakness or clumsiness of your hand
- Loss of grip strength
- Difficulty touching your little finger with your thumb
- Frequently dropping things
- Pain extending up your arm
Diagnosing Carpal Tunnel Syndrome
The doctor will ask about your symptoms and medical history. An examination of your neck, arms, wrists, and hands will be done. The physical exam will include tests of strength, sensation, and signs of nerve irritation or damage. The physical exam may include:
Tinel's Sign - The doctor will tap firmly on your wrist right over the carpal tunnel to see if it sends an electric shock feeling into your hand. You can also do this test yourself. Tap right over the creases on the inner side of your wrist between the two bones on either side of the base of your palm.
Compression Test - The doctor will bend your wrist down so that your thumb comes as close to your forearm as it will go. It will be held for a minute or two to see if it causes tingling and numbness in your hand.
Other tests may include:
Nerve Conduction Study - The speed at which your nerves carry signals can be determined by stimulating them with tiny electrodes attached to special machines. If conduction is slowed through the carpal tunnel, you probably have a problem in the carpal tunnel.
Electromyogram (EMG) - In a similar fashion, tiny currents can be used to stimulate muscles. The muscles respond with electrical activity that can be measured. When the nerves connecting to muscles are damaged, the muscles give off abnormal signals.
X-rays, CT Scan, and MRI Scan - These imaging tests may identify other causes of carpal tunnel syndrome. They may also give more detailed information about your particular problem.
Ultrasound - a test that uses sound waves to measure the diameter of the median nerve. It may be used as a screening test or to guide injections.
Arthroscopy - This procedure is useful in both diagnosing and treating carpal tunnel syndrome. This is a minor surgical procedure during which a thin, lighted tube (arthroscope) is inserted into your wrist. The surgeon can then look through the tube to see exactly what is wrong. The same tube can be used to repair the problem using tiny tools inserted through the arthroscope into the wrist.
Treating Carpal Tunnel Syndrome
The treatment and management of carpal tunnel syndrome requires that pressure in the carpal tunnel be reduced. There are several ways to do this. As with all health problems, the safest and simplest treatments are tried first. If your carpal tunnel syndrome is due to another treatable condition, such as diabetes or a hormone disorder, that condition may be treated first to see if the carpal tunnel syndrome resolves. To treat carpal tunnel syndrome directly, the options are:
- Rest and exercises
- Cortisone injections
Concerned about carpal tunnel syndrome? Please call our Joint and Spine Center Navigator at (615) 781-5870 to make an appointment with one of our specialists.