There are eight bones found in your wrist that form a U-shaped channel that houses several tendons and your median nerve. The carpal tunnel is the name for this passageway. The median nerve controls your feeling and vibration on the palm side of your first three and a half 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. Vibration and cold have also been known to aggravate or exacerbate the disease.
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. Carpal tunnel syndrome may also be caused by fluid retention during pregnancy.
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. Symptoms typically begin as nighttime pain or waking up with numb hands, but they can quickly escalate into a persistent irritation.
Gripping activities, such as holding a book while reading, driving, or painting, are likely to aggravate your symptoms. 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 in the carpal tunnel is often followed by compression in another or third location. This is referred to as "double crush syndrome" by researchers." 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. Our office can recommend a special splint to help with your nighttime symptoms by keeping your wrist in a neutral or slightly extended position.
Carpal tunnel syndrome can result in permanent nerve damage to your forearm if left untreated. The American Academy of Neurology recommends conservative treatment, like the type provided in our office, before going down the surgical route.