Carpal Tunnel Syndrome: Causes, Symptoms, and Treatment

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition that causes numbness, tingling, pain, and other symptoms on the wrist. Carpal tunnel syndrome is caused by compressed nerves in the carpal tunnel, a narrow passageway on the side of the palm. In this tunnel there is a median nerve that functions to control the finger muscles and receive stimulation from the skin in the hand area.

Causes of Carpal Tunnel Syndrome

Carpal tunnel syndrome or better known as CTS is generally caused by pressure on the median nerve that is swollen. Swelling, in turn, can be caused by several reasons, such as:

  • Diabetes.
  • Thyroid dysfunction.
  • Fluid retention from pregnancy or menopause.
  • High blood pressure.
  • Alcoholism.
  • Autoimmune disorders such as rheumatoid arthritis.
  • Endocrine disorders such as diabetes and hypothyroidism.
  • Fractures (broken bones) on the wrist.

In addition to some of the factors described above, activities that involve strong grips, repetitive wrist movements, and strong vibrations in the hands can trigger CTS. These activities include the work of the packaging, the use of cutting tools, to playing music.

Even so, until now more in-depth research is still being done whether carpal tunnel syndrome is directly related to work that involves a lot of hand movements.

Those at Risk of Carpal Tunnel Syndrome

Women are three times more likely to experience carpal tunnel syndrome than men. This disease is also most commonly diagnosed between the ages of 30 and 60 years. In addition, lifestyle factors can also increase the risk of carpal tunnel syndrome such as smoking, high salt intake, sedentary lifestyle, and high body mass index.

Because CTS is a disorder that causes problems in the wrist, some jobs that are at risk of causing carpal tunnel syndrome are jobs that involve repeated use of fingers, including:

  • Manufacturing or packaging work.
  • Construction work.
  • Milker.
  • A painter.
  • A musician who often uses stringed instruments.
  • Office workers who often use the mouse and keyboard.

Symptoms of Carpal Tunnel Syndrome

Carpal tunnel syndrome is characterized by the appearance of a sensation of numbness in the fingers. These symptoms may be caused by the hands and wrists being in a relaxed and supple position while asleep. Symptoms are usually worse at night and sometimes symptoms temporarily subside with a flick of the hand.

Other symptoms that usually appear include:

  • Incurred pain, usually pain like burning.
  • Tingling in the thumb, index, and middle finger. Pain will appear when you move your arm
  • Weakened hand.
  • Difficulty feeling and holding small objects.

If symptoms persist, you should see a doctor immediately.

Carpal Tunnel Syndrome Diagnosis

To determine the diagnosis of carpal tunnel syndrome, the doctor will usually perform a physical examination on the hands and wrists. One that will be evaluated is the range of wrist movement.

People who have experienced wrist injuries usually experience abnormalities in the range of motion of the wrist. The strength of the hands and fingers can also be checked, using a healthy hand side ratio. In addition, doctors can also ask a number of questions related to symptoms experienced through a series of medical interviews.

Here are some tests that can be used to determine the diagnosis:

  • Electromyography.
  • Nerve conduction studies.
  • Physical test.
  • Blood test.
  • X-ray.

In addition to several tests that you have to undergo, you may also be referred to a neurologist, rheumatologist, or orthopedic surgeon to evaluate the condition of the nerve or the possibility of arthritis that leads to carpal tunnel syndrome.

For people who have carpal tunnel syndrome, measuring electrical activity in the hand muscles can reveal signs of muscle damage. Carpal tunnel syndrome usually involves half your thumb up to half of your ring finger.

Carpal Tunnel Syndrome Treatment

Carpal tunnel syndrome often does not require special treatment because this condition can resolve on its own within a few months. If CTS does require treatment, the treatment depends on the severity and how long you have been suffering from this condition.

Here are the treatments that can be done, including:

1. Physiotherapy

Physiotherapy management in the case of carpal tunnel syndrome to reduce pain is very diverse, usually using Microwave diathermy, ultrasound, and peripheral nerve mobilization.

Physiotherapy can also help restore the strength of the hands after surgery. Not everyone needs therapy after surgery, but for some people this can be very helpful.

Some people can resume light activities three to four weeks after surgery and can do heavy work six weeks postoperative. After undergoing surgery, you can also try physiotherapy to reduce swelling, stiffness, and pain after surgery.

Some patients may benefit from exercises that help the median nerve move more freely. Specific exercises can be recommended by a doctor or therapist.

2. Using Bracing or Splinting

Using bracing or splinting will keep you from bending your wrists during sleep. Keeping the wrist in a straight or neutral position can reduce pressure on the nerves in the carpal tunnel. Both of these tools can also be used during the day when activities that worsen symptoms.

3. Changes in Activity

Symptoms of carpal tunnel syndrome will occur if the wrist is in the same position for a long period of time, especially when the wrist is bent. If this condition makes the symptoms worse, you must change the position of the wrist

4. Anti-inflammatory drugs

Carpal tunnel syndrome is an inflammatory process. However, pain is a common complaint, and anti-inflammatory drugs are sometimes used to treat the pain. Anti-inflammatory drugs such as ibuprofen may provide a little comfort because of reduced pain, but do not cure carpal tunnel syndrome.

Meanwhile, direct injection of steroid drugs by doctors into the carpal tunnel has proven to be an effective treatment for some people with this syndrome.

5. Surgery

If non-surgical treatment has failed to overcome this syndrome, surgical treatment can be considered. The goal of surgery is to take pressure from the nerves in the wrist.

The surgeon will make a small cut on the palm side of the wrist and then release the ligament that covers the carpal tunnel. By releasing ligaments, the size of the carpal tunnel increases and the pressure feels relieved on the nerves in the carpal tunnel.

Overall, surgery is safe, but still has risks, including infection, difficulty healing wounds, stiffness, wound pain, and nerve injuries. Some people will feel comfortable after the pressure on the nerves is removed by surgery.

Most people feel comfortable using their hands for light activities within a day or two after surgery. Even so, most cases of CTS do not require surgery.

Complications of Carpal Tunnel Syndrome

Carpal tunnel syndrome can cause permanent damage to the wrist nerve, so the hands and fingers cannot be moved. Continuous pain (chronic pain) can also occur in people with carpal tunnel syndrome.

Although complications can occur with surgery, the doctor will take steps to minimize the risk. The most common complications of carpal tunnel syndrome surgery include:

  • Bleeding.
  • Infection appears.
  • Nerve swelling or injury.

Prevention of Carpal Tunnel Syndrome

Until now there has been no evidence that can prevent carpal tunnel syndrome. However, there are several steps you can take to minimize stress on the wrist, including:

1. Reducing Grip Strength

If you work a lot using the keyboard or using the cash register, try pressing the button gently. Meanwhile, if you are required to use a lot of handwriting, choose a pen with a large, soft grip.

2. Get plenty of rest

Do stretches with bend your hands regularly. Relaxation time is needed for those of you who use vibrating equipment or who require a lot of effort.

3. Adjust the Position of the Wrist

If you are required to do a lot of activities with your hands, avoid the position of bending the wrist up or carrying it. Keep the keyboard at elbow level or slightly lower.

4. Change Body Posture

Posture that is too bent forward can shorten the neck and shoulder muscles, and compress the nerves in the neck. This condition can affect the condition of the wrist and fingers.

Some people recommend hand movement exercises including yoga and massage, but research has not yet confirmed that this method is effective for treating carpal tunnel syndrome.

5. Keep Hands Warm

You are more likely to experience hand pain and stiffness if you work in a cold environment. If you can’t control the temperature at work, wear gloves that keep your hands and wrists warm.

7. Use a Comfortable Device

If work requires you to linger in front of the computer, make sure the mouse is comfortable and does not strain your wrists. Although there is no evidence that using a computer increases the risk of carpal tunnel syndrome, an ergonomic mouse and keyboard can reduce tension by helping to keep the hands in a good position.

Eventually, if carpal tunnel syndrome does not go away, permanent nerve injury may cause numbness and weakness and atrophy (shrinkage) of the muscles in the hand. Treatment must be done immediately to maintain hand function.

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