At the base of the palm is a tight canal or tunnel through which tendons and nerves must pass on their way from the forearm to the hand and fingers. The nerve that passes through this narrow tunnel to reach the hand is called the Median Nerve. This narrow passage between the forearm and hand is what is known as the "Carpal Tunnel".
The Carpal Tunnel is normally quite snug and there is just barely enough room in it for the tendons and nerves that have to pass through it. If anything takes up extra room in the canal, things become too tight and the nerve in the canal becomes constricted or "pinched"
This pinching of the nerve (a medical condition referred to officially as Nerve Entrapment) causes numbness and tingling in the area of the hand that the nerve travels to. The condition that results when the Median Nerve is being pinched in The Carpal Tunnel is commonly referred to as Carpal Tunnel Syndrome or "CTS".
In actuality, the condition and its accompanying symptoms can be brought on by either a decrease in the size of the carpal tunnel OR an enlarging of the tissues inside the tunnel.
Carpal Tunnel Syndrome has received a lot
of attention in recent years because of suggestions that it may be linked
with occupations that require repeated use of the hands, such as typing on a
computer keyboard or doing assembly work. In reality, many people develop
this condition regardless of the type of work they do.
What Are The Symptoms Of Carpal Tunnel Syndrome?
One of the first symptoms of CTS is gradual numbness in the areas supplied by the median nerve. This is quickly followed by pain where the nerve gives sensation in the hand. The hand may begin to feel like it's "asleep," especially in the early morning hours after a night's rest.
Pain may spread up the arm to the shoulder and even to the side of the neck. If the condition progresses, the thenar muscles of the thumb can weaken and atrophy, causing the hand to be clumsy when picking up a glass or cup. If the pressure keeps building in the carpal tunnel, the thenar muscles may actually begin to shrink (atrophy).
Touching the pad of the thumb to the tips of the other fingers becomes difficult, making it hard to grasp items such as a steering wheel, newspaper, or telephone.
For many unfortunate sufferers, CTS has a
pattern of flaring up through the night thereby making sleep difficult. CTS symptoms can
also be expected to arise frequently while performing the activity that is the cause of
the condition in the first place.
Physicians normally identify the condition by first obtaining a history of the problem, followed by a thorough physical examination. Your description of the symptoms and the physical examination are the most important parts in the diagnosis of CTS. Commonly, patients will complain first of waking in the middle of the night with pain and a feeling that the whole hand is asleep.
Careful investigation usually shows that the little finger is unaffected. This can be a key piece of information to make the diagnosis. If you awaken with your hand asleep, pinch your little finger to see if it is numb also, and be sure to tell your doctor if it is or is not. Other complaints include numbness while using the hand for gripping activities, such as sweeping, hammering, or driving.
If your symptoms started after a traumatic wrist injury, X-rays may be needed to check for a fractured bone.
If more information is needed to make the
diagnosis, electrical studies of the nerves in the wrist may be requested by
your doctor. Several tests are available to see how well the median nerve is
functioning, including the nerve conduction velocity (NCV) test. This test
measures how fast nerve impulses move through the nerve.
Treatments For Relieving Carpal Tunnel Syndrome
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