It normally develops between the ages of 45 and 64 years, and the prevalence increases with age. It can appear in one or both wrists. It is more common in women than in men. Eventually, the median nerve can become severely damaged, and there may be permanent numbness in the fingers and permanent weakness in the muscles that are innervated by the median nerve. It is often linked to computer use, but reports date back to the s. It was familiar to orthopedic surgeons since before the widespread use of computers.
The first symptoms often appear during the night, or on waking up in the morning. The discomfort may wake them repeatedly during the night. These symptoms occur in the thumb and the two fingers next to it, as well as half of the ring finger. They may extend to the rest of the hand and into the forearm. As the condition progresses, symptoms may persist during the day.
The person may lose grip strength and find it harder to form a fist or grasp small objects. Opening a bottle of soda, doing up buttons, or typing on a keyboard can become a challenge. If left untreated, the muscles at the base of the thumb may wither away, and the person may no longer be able to tell hot from cold with the thumb and finger. Symptoms tend to emerge or get worse after using the affected hand. The sensation of tingling, burning, and pain may worsen if the arm or hand has been in the same position for a long time.
Treatment aims to relieve symptoms and slow the progression of CTS by reducing pressure on the median nerve. People with mild symptoms may find their condition improves without treatment within a few months, especially if they are aged 30 years or under or if CTS occurs during pregnancy.
Most patients with mild symptoms who follow these strategies will notice an improvement within 4 weeks. The doctor may recommend corticosteroid injections to reduce inflammation. These are normally applied by injection, directly into the carpal tunnel. Tablets are available, but they are usually less effective. At first, the pain may increase, but it should start to reduce after 2 days. If the response is good, but symptoms return after a few months, another dose may be recommended.
However, continued use of corticosteroids is not advisable, as there can be long-term adverse effects. Who is at risk of developing carpal tunnel syndrome? How is carpal tunnel syndrome diagnosed? How is carpal tunnel syndrome treated?
How can carpal tunnel syndrome be prevented? What research is being done? Where can I get more information? Carpal tunnel syndrome CTS occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. The carpal tunnel—a narrow, rigid passageway of ligament and bones at the base of the hand—houses the median nerve and the tendons that bend the fingers.
The median nerve provides feeling to the palm side of the thumb and to the index, middle, and part of the ring fingers although not the little finger.
It also controls some small muscles at the base of the thumb. Sometimes, thickening from the lining of irritated tendons or other swelling narrows the tunnel and compresses the median nerve.
The result may be numbness, weakness, or sometimes pain in the hand and wrist some people may feel pain in the forearm and arm. Symptoms usually start gradually, with frequent numbness or tingling in the fingers, especially the thumb and the index and middle fingers. Some people with CTS say their fingers feel useless and swollen, even though little or no swelling is apparent. If the diagnosis is not clear, we may refer patients to have a nerve conduction study as well. Your fingers are free to move and you may have some soreness in your wrist but, generally, patients get back to regular activities after about two to four weeks.
Patients who have long-standing or severe symptoms may require a longer period of time and may not get back a hundred percent of their function that they had before. It can recur although we often see this 10, 15 years down the line and that can be treated if it comes up. Your provider will check your medical history and give you a physical exam. He or she may recommend that you have electrodiagnostic tests on your nerves. These tests are the best way to diagnose carpal tunnel syndrome.
Electrodiagnostic tests stimulate the muscles and nerves in your hand to see how well they work. Splinting your hand. This helps keep your wrist from moving. It also eases the compression of the nerves inside the tunnel. Anti-inflammatory medication. These may be oral or injected into the carpal tunnel space. These reduce the swelling.
Worksite changes. Changing position of your computer keyboard or making other ergonomic changes can help ease symptoms. Back to Health A to Z. Carpal tunnel syndrome CTS is pressure on a nerve in your wrist. It causes tingling, numbness and pain in your hand and fingers. You can often treat it yourself, but it can take months to get better.
These symptoms often start slowly and come and go. They're usually worse at night. CTS sometimes gets better by itself in a few months, particularly if you have it because you're pregnant. A wrist splint is something you wear on your hand to keep your wrist straight. It helps to relieve pressure on the nerve.
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