There are eight bones found in your wrist that form a U-shaped channel that houses several tendons and your median nerve. This channel is known as the carpal tunnel. Your median nerve is responsible for your feeling and your sensation on the palm side of your first 3 ½ fingers.
Compression or irritation of this nerve as it travels through the carpal tunnel is responsible for the creation of a condition known as Carpal Tunnel Syndrome (CTS). CTS is currently the most common nerve entrapment, affecting 3-5% of the general population. Females are affected roughly two or three times more often than males. Carpal tunnel syndrome most often is found in adults age 45-60.
CTS can be caused by prolonged wrist flexion and/or repetitive wrist motions like supermarket scanning, keyboard use, carpentry or assembly line work. Exposure to vibration or cold is also known to aggravate the condition or worsen it.
Carpal Tunnel Syndrome is more common in your dominant hand but can also frequently affect both hands. Some risk factors for developing CTS include diabetes, thyroid disease, rheumatoid arthritis, alcoholism, kidney disease, and being short or overweight. Fluid retention during pregnancy is also a common cause of carpal tunnel symptoms.
Symptoms of CTS include numbness, tingling or discomfort on the palm side of your thumb, index, middle finger and half of your ring finger. The pain and discomfort you feel can also sometimes extend towards your elbow.
The symptoms you experience usually start as nighttime discomfort or waking up with numb hands, but can rapidly progress to a constant annoyance.
Your symptoms are likely aggravated by gripping activities such as holding a book while reading, driving or painting. Early on, your symptoms may be reduced by simply "shaking your hands out". You may sometimes feel as though your hands are tight or swollen. In more severe cases, hand weakness can form.
Compression of the median nerve that is found in the carpal tunnel is often accompanied by compression at a second or third site as well. Researchers call this "double crush syndrome." Common "double crush" partners for CTS also involve the spine or muscles in and around your neck, shoulder and forearm.
To help resolve your condition, you should do your best to avoid activities that involve repetitive wrist flexion, i.e. pushups. Grasping the handlebars on your bicycle will likely increase irritation of your condition. We may prescribe a special splint that keeps your wrist in a neutral or slightly extended position that will help with your nighttime symptoms.
If left untreated, carpal tunnel syndrome can cause your forearm to sustain permanent nerve damage. The American Academy of Neurology recommends conservative treatment, like the type provided in our office, before going down the surgical route.
Arm, wrist, and hand pain is common when working at a computer, working with construction tools, nursing or carrying children, and participating in racquet and swinging sports.If you are experiencing arm, wrist, or hand pain that is not a result of an acute injury, our physicians will examine to determine if the pain is due to nerve sensitivity, muscle or tendon strain, or joint dysfunction.
We will then apply modern, research-driven rehabilitation approaches to recover function and overcome pain. Once we restore movement in your arm it is important to increase strength to prevent future issues.We have built a special program for this in our in-house Foundational Fitness classes. If you have an acute injury to your arm, wrist, or hand our doctors will examine, order imaging as indicated, and formulate a plan for recovery.