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Carpal Tunnel Syndrome

By Sasha de Beausset Aparicio, MSc

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What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a condition of the median nerve, located along the hand and palm, which manifests through intense pain at the palm and wrist level, numbness of fingers, and difficulties in normal usage of the hand. The main cause for the Carpal Tunnel Syndrome is physical stress on the median nerve, which innervates the muscles in the hand. By creating pressure on the canal that the nerve is located in, it starts to disturb the way it receives and sends signals, which will eventually lead to distorting its normal function.


People who do hard manual labor are more predisposed to form this syndrome, by repeatedly stressing the wrist and palm, and also athletes. But this can occur on lower levels of stress also, as an improper position of the hand during normal house work or even at the office. Repeated cases on typewriters and people who use a keyboard are a very good example, as they usually tend to stress the median nerve when holding the palms on the desk.

In some cases, the disorder can be induced through a short trauma in the region of the nerve, which, despite the fact that the duration was short, can cause permanent or temporary damage to the nerve; in some instances, it can even lead to paralysis.

Pregnant women Syndrome and people with hormonal imbalance or diabetes can experience Carpal Tunnel. Usually any disorder that cause swelling to the nerve area can lead to the appearance of the syndrome.

An improper nutrition can cause the symptom by gradually weakening all the factors that keep the nerve function healthy or structure intact, atrophy or obesity are a known to cause it, or apparition of edemas.

Signs & Symptoms

The first signs are numbness of the fingers, except the little finger which is not innervated by this nerve. Pain usually radiates from the wrist or between the phalanges. This can occur mostly at night, when the wrist is hold in a flexed position and the nerve activity is higher. In more severe cases, the pain can be felt all across the hand, between the tips of the fingers to the elbow. The patients may experience itching and burning sensations on the skin close to the area where the pain comes from. The symptoms can occur on any hand, it depends on the stress level of each one.

The numbness can turn into difficulties moving the hand and palm, especially when holding a fist. The opposable thumb becomes harder to use in grabbing or holding objects. Shaking can occur, especially after trauma or after a short time since the physical effort.

One of the most important symptoms is weakened tactile sense that occurs when the damage to the nerve is causing the more sensitive signals to lose strength. This can influence the way the patient performs even the easiest tasks. Each physical effort becomes harder and symptoms start to worsen when the patient continues to expose himself to more damaging stimuli.

Diagnosing Carpal Tunnel Syndrome

First steps towards diagnosing this symptom are an accurate patient history, which indicates habits or other circumstances in which physical stress over the nerve area may be occurring. Keeping track of the evolution of symptoms is also important, as this condition degrades in time.

Physical signs of the syndrome can be found through a series of tests which concern the mobility of the hand, coordination and any signs of atrophy along the hand and palm muscles. If needed, reflex tests can be done to observe the reaction when the nerve is stimulated through a small blow or pinch in a soft skin area along its path.

There are possibilities to test the physical structure of the nerve using laboratory equipment, through which the speed of an electric signal passing through can be measured, signs of an obstruction or anything that can delay the normal function.

Treatment for Carpal Tunnel Syndrome

First treatment method is quitting any form of physical effort that puts more stress on the affected nerve. Further stress will make any attempt to recover impossible. If the condition is considered less severe by the doctor, a home treatment is possible. This can be done through special exercises to relax and flex the hand periodically. Anti-inflammatory medication is usually prescribed and, in cases of patients who have problems during sleep, it is recommended a special glove that holds the wrist and palm in fixed position so that it cannot be flexed or clenched.
If the symptoms do not show any signs of improvement, further medical assistance is needed. Surgical treatment is used in the most severe cases, in which the pressure on the nerve is lowered by several incisions in the tunnel that holds it in place.

A preemptive treatment consists in eliminating stress on the nerve area for long periods of time. If it is not an option, brakes followed by exercises is recommended, for example shanking gently your hand in a downwards position will relax the palm and the wrist. If the patient has the habit of using one hand more than the other when performing physical labor, it is recommended that they alternate to shorten at least the stress intervals if not the duration.

Sleep position can play an important role, especially if the patient sleeps on the side, which puts more stress on the hands, and also elevates the risks of the hands to stay in improper positions that can harden the recovery.

Acupuncture is one of the most effective alternative medicine treatments for Carpal Tunnel Syndrome, through which nerves are stimulated and the chances of recovery improve, especially the feel sensation.

For people working at the office it is recommended that a proper position when sitting at the desk is maintained, and if they use a computer wrist pads are necessary to keep the hand in a less stressful position for long periods of time.

Having a healthy and balanced life through workout and proper nutrition is the best treatment, especially for preventing other complications that eventually lead to the apparition of the symptom.