Carpal tunnel syndrome (CTS) is the medical term for compression of the median nerve, which runs from the forearm into the palm. The medial nerve controls sensation and – to some degree, movement – of the thumb and first three fingers. The nerve runs through a narrow passageway between bones and ligaments in the wrist. If the tunnel narrows, it causes pressure on the median nerve and results in CTS.
The initial symptoms of CTS are usually very mild and begin gradually, often at night and in the dominant hand. Patients typically report itching, burning, tingling or numbness in the palm and fingers. Although there is not usually any apparent swelling, some patients say their hand feels swollen. As the condition progresses, numbness and tingling become more pronounced, grip strength decreases and people often complain of pain in the wrist area.
Carpal tunnel syndrome is not usually a problem of the median nerve itself, but of conditions that narrow the carpal tunnel and put pressure on the nerve. Some people simply have a smaller tunnel, which is probably congenital. Injuries like sprains and fractures, work stress and the use of vibrating hand tools or a computer keyboard may contribute to the condition. The hormonal changes of pregnancy and menopause may also contribute to the development of carpal tunnel syndrome. Women are more likely to develop CTS than men, and people with diabetes have a higher risk than the general population.
Initially, treatment of CTS is conservative: rest, the use of wrist splints and cold treatment. Any underlying condition like diabetes or arthritis should also be treated. Medications may be used to relieve pain and reduce swelling or inflammation. Some patients find vitamin B-6 supplements, gentle stretching exercise, yoga and acupuncture helpful. If conservative treatment is unsuccessful, surgery to enlarge the carpal tunnel may be required. Although recovery takes months, very few patients experience a recurrence of CTS after surgery.
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