What is Carpal Tunnel Syndrome? 

Carpal tunnel syndrome (CTS) is one of the most common of conditions that affect the hand or hands. The common signs of the presence of the problem are pain, tingling sensation, weakness and/or general numbness in the hand or wrist. This is a medical condition that has been known for a very long time, but it has become a well-known ailment with the onset of the electronic age and the increased use of computers. There is a mistaken impression that it affects only office workers and in particular those who spend time working on computers and electronic equipment. The assumption is that continuous typing and the use of the mouse cause stress to the hands and wrists resulting in the onset of CTS. The fact is that it can affect anyone who is involved in any activity, including sports and pastimes, that require repeated use of the hands and wrists. CTS affects people who do not and never have worked in an office or spent time on computers.

The carpal tunnel is a narrow tube in the wrist. Similar to a tunnel that a car or train passes through, the carpal tunnel is the conduit through which the nerves and tendons that control the movement of the wrists, hands and fingers pass through. When the tunnel becomes compressed or when there is increased pressure on the nerves and tendons, CTS can develop.

Causes

Any repetitive motion of the wrist, hand or fingers can result in the development of CTS. Among the most common of these are extreme wristmotions, continuous stress on the hands and wrists, vibration and repeated high force or impact.

Many factors could contribute to the development of CTS. These include, but are not limited to:

• Genetic or Hereditary Factors - If others in the family have CTS, you are more likely to develop the condition.
• Hand or wrist deformity
• Injury
• Pregnancy
• Medical procedures such as haemodialysis
• Dislocation of the wrist
• Diseases such as diabetes, gout or rheumatoid arthritis
• Thyroid gland related hormonal imbalance
• Old age
• Excessive alcohol consumption over a long period of time
• A tumor in the hand or wrist
• Excessive protein deposits in the carpal tunnel

While both sexes suffer from CTS, statistics show that it is more common in women than men.

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Treatment

Both surgical and non-surgical treatment options exist for CTS. Only a doctor will be able to decide which option is the best for each patient.That said, non-surgical treatments are used for less severe cases while surgery is often recommended for more serious cases. Because surgical options have a very high positive outcome rate, they may be used when the effectiveness of non-surgical options is doubtful for less serious cases.

Non-Surgical Treatments

Non-surgical treatment typically consists of one or a combination of the following:

• Wearing a wrist splint to relieve the stress on the wrist and the carpal tunnel
• Cortisone injections
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs)
• Physiotherapy to reduce pressure on the tunnel
• Heat treatment

Besides these direct medical interventions, environmental changes are often prescribed to reduce the symptoms of CTS. These changes could be to the home or the workplace or, frequently, to both and include:

• Altering the height of a chair in which you spend a great deal of time.
• Changing the chair to increase support to the spine and the forearms.
• Changing the position of a computer keyboard, mouse and other desktop equipment.
• Modifying the posture and the position of the hands and wrists while performing tasks, especially repetitive ones or those that cause sudden stress or impact to the hands and wrists.

Surgical Treatments

Surgery is advised if CTS does not respond to other treatments or if the condition is so severe that non-surgical options will not work. The object of the surgery is to increase the size of the carpal tunnel to decrease the pressure on the nerves and tendons that pass through it. One way of doing this is by surgically releasing the ligament that covers the tunnel at the base of the palm to reduce the constriction.

• The surgery itself is an outpatient procedure done under local anaesthesia. In some cases, perhaps because of other medical factors, your doctor may recommend that it be done under general anaesthesia.
• The surgery will require a 3-to-4-day recovery period, although some degree of relief may often be felt immediately after the surgery. During the recovery period, there may be some general post-surgical pain or discomfort. If it is too severe, pain reduction medication will be prescribed.
• Stitches will be removed about 2 weeks after the surgery and exercise programmes to restore strength and flexibility to the hands, fingers and wrists will begin.
• While recovery time will vary according to age and other medical factors, full recovery will typically take 4 to 6 weeks.
• Over the next few months,strength and sensation will gradually return to the wrists, hands and fingers.

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CTS is not a life-threatening condition, but it is one that should not be ignored. Occasional slight pain in the wrists, hands or fingers after long periods of work or repetitive activity is common. However, if thepain is severe or the functionality of the hands is affected, then it could be CTS. When CTS is suspected, the sooner the condition is diagnosed and treatment started,faster the recovery. If you suspect you have CTS, go to a multispecialty hospital where there will be orthopaedic and other specialists and medical facilities to provide you with both the most accurate diagnosis and the best treatment for the condition. Any ailment that affects the functioning of the hands can have a negative impact on your life and delay in obtaining a diagnosis and starting treatment may leave you with long-term problems that will require more extensive treatment and a longer recovery period.

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