What Is Carpal Tunnel Syndrome?

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An overview of carpal tunnel syndrome

Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve is compressed at the wrist joint and causes a neuropathy condition. 

Which anatomical structures are involved in carpal tunnel syndrome?

The median nerve is derived from the nerves at vertebrae C6, C7, C8, and T1 and then runs through the forearm into the palm of the hand. The “carpal tunnel” is a tunnel or passageway at the wrist. It’s formed from the carpal bones on the dorsal side and the transverse carpal ligament on the palm side of the hand. The median nerve as well as the flexor tendons for the forearm pass through the carpal tunnel. The median nerve innervates the thumb and first two fingers, on the palm side of the hand, as well as the median side of the fourth finger.

What are the symptoms of carpal tunnel syndrome?

Symptoms of this condition can include tingling, numbness, and/or pain in the fingers which are innervated by the median nerve. Additionally, grip strength and general function may be reduced in the affected hand. Similar symptoms can be caused by a variety of other conditions such as: pronator syndrome, anterior interosseous nerve syndrome, thoracic outlet syndrome, cervical radiculopathy, brachial plexopathy, and central nervous system disorders among others. So, it’s very important to have a thorough evaluation of any symptoms that you experience.

What causes carpal tunnel syndrome?

Anything that reduces the space in the carpal tunnel enough that it results in the compression of the median nerve can contribute to carpal tunnel syndrome. There is some debate about what the causes are, although genetics, injuries and accidents, tumors or non-cancerous lesions, and work or sport-related repetitive movements have all been implicated. Sometimes there appears to be no clear cause.

How is carpal tunnel syndrome diagnosed?

There are several methods currently used to aid in the diagnosis of carpal tunnel syndrome. Research suggests that a combination of the available methods increases the accuracy of diagnosis because each of the individual methods alone can produce false positives and/or false negatives. A thorough intake describing the symptoms being experienced and the contexts in which the symptoms are experienced or relieved is a good first step.

Other diagnostic tests used include:

  • Phalen’s test
  • Tinsel’s test
  • Nerve conduction studies
  • Diagnostic CT scale
  • Symptom severity scale
  • Functional scale
  • Katz hand diagram
  • Hand elevation test
  • Ultrasounds
  • MRI

And others!

How is carpal tunnel syndrome treated?

Non-surgical treatment, usually for those with mild to moderate symptoms, can include: hand splints, yoga, mobilization of the carpal bones, steroids, corticosteroids, vitamins B6 and B12, or non-steroidal anti-inflammatory drugs (NSAIDS). In the surgical treatment, the transverse carpal ligament is cut to make space in the carpal tunnel. The procedure is called a carpal tunnel release.

As with any condition, consult the appropriate professional to do a thorough examination of your symptoms if you are concerned about carpal tunnel syndrome. If you’d like to read more about muscle function and dysfunction sign up to our mailing list.

References

Ibrahim, I., W.S. Khan, N. Goddard, and P. Smitham. 2012. Carpal tunnel syndrome: A review of the recent literature. Open Orthopaedics Journal. 6:69-76.

Kim, P-T., H-J. Lee, T-G. Kim, and I-H. Jeon. 2014. Current approaches for carpal tunnel syndrome. Clinics in Orthopedic Surgery. 6(3):253-257.

Carpal Tunnel Syndrome Information Page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Carpal-Tunnel-Syndrome-Information-Page Accessed: June 4, 2019.