Carpal Tunnel Syndrome

Definition:
Carpal tunnel syndrome is a relatively common condition that causes inflammation of the tendons and tissues in the wrist. This swelling occurs when prolonged pressure is applied to the median nerve and synovium in the carpal tunnel. In most patients, carpal tunnel syndrome develops gradually and causes moderate to severe pain on the thumb-side of the hand. However, symptoms can change and vary in intensity depending on the severity of the condition. If left untreated, carpal tunnel syndrome could lead to permanent nerve and muscle damage.

Causes:
This condition typically develops from repetitive wrist and hand motions that cause compression of the median nerve. A number of other health, anatomic, and workplace factors may increase a person’s risk of developing this condition. Nerve-damaging conditions, inflammatory diseases, pregnancy, menopause, obesity, and thyroid disorders can all lead to carpal tunnel syndrome as well. When the median nerve in the carpal tunnel becomes irritated and crowded, swelling ensues, resulting in pain and other symptoms.

Symptoms:
Symptoms of carpal tunnel syndrome may begin as numbness or tingling in the thumb that radiates toward the index and middle fingers. This sensation may come and go, or worsen as the condition progresses. Patients may experience relief after shaking out their hands or stopping activities that exacerbate symptoms. Pain or discomfort may be present, but more often than not, patients experience tingling, numbness, and muscle weakness in the wrist and hand.

Treatments:
While conservative therapies can effectively mitigate carpal tunnel syndrome, interventional pain care and minimally invasive surgery are often the preferred treatment methods. This is especially true for patients who cannot stop or modify the behavior that caused the condition in the first place. Nonsurgical treatment of carpal tunnel syndrome generally includes over-the-counter pain relievers, wrist splinting, ice, and rest. Oral medications or interventional (injections) corticosteroids may also help decrease inflammation and pain related to carpal tunnel syndrome. If the patient’s symptoms continue, endoscopic surgery may be recommended for treatment.

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