Carpal Tunnel Syndrome: A Patient’s Guide

Carpal tunnel syndrome (CTS) is a common condition that can affect your hand function, making everyday activities difficult. It causes pain, numbness, and weakness in the hand and fingers. Understanding why this happens and how to treat it can help you regain comfort and mobility.

CTS occurs when the median nerve, which runs through your wrist, gets compressed in a narrow passage called the carpal tunnel. This tunnel is formed by small wrist bones and a ligament, leaving little room for swelling or irritation. When pressure builds up, it can reduce blood flow to the nerve, leading to symptoms such as tingling, pain, and muscle weakness.

Symptoms usually develop gradually and may come and go at first. However, as the condition progresses, discomfort can become more frequent and severe.

Symptoms include:

• Numbness and tingling in the thumb, index, middle, and ring fingers, often waking you up at night
• Pain that can spread from the wrist to the forearm
• Weakness in the hand, making it hard to grip objects
• A sensation of swelling in the fingers, even if no visible swelling is present

Certain factors can increase the likelihood of developing CTS, including:

• Gender: Women are more likely to develop CTS due to naturally smaller carpal tunnels and hormonal changes (pregnancy, menopause).
• Repetitive Hand Movements: Activities like typing, sewing, or using vibrating tools can strain the wrist.
• Medical Conditions: Diabetes, thyroid disorders, rheumatoid arthritis, and obesity can contribute to nerve compression.
• Injury or Trauma: Wrist fractures or sprains may lead to swelling and increased pressure on the nerve.

• Take regular breaks when using your hands for prolonged periods.
• Keep your wrists in a neutral position (not bent too much forward or backward).
• Perform wrist and hand stretches to improve circulation and reduce tension.
• Ensure an ergonomic workspace, with proper desk and keyboard positioning.

If you have persistent symptoms, a doctor can perform tests to confirm CTS. Common methods include:

• Tinel’s Test: The doctor taps on the median nerve at the wrist. Tingling in the fingers may indicate CTS
• Phalen’s Test: Holding the wrists in a bent position for a minute may trigger numbness or pain.
• Durkan’s Test: The doctor applies direct pressure over the carpal tunnel for about 30 seconds. If this causes numbness or tingling, CTS is likely.
• Nerve Conduction Studies & Electromyography (EMG): These tests measure nerve function and help determine the severity of the condition.

If diagnosed early, CTS can often be managed without surgery. Treatment options include:

Non-Surgical Treatments

• Wrist Splinting: Wearing a brace, especially at night, keeps the wrist in a neutral position and reduces pressure on the nerve.
• Cold Therapy: Ice packs can reduce swelling and pain.
• Exercises: Gentle stretching and strengthening exercises may help relieve symptoms.
• Medications: Pain relievers like ibuprofen or corticosteroid injections can reduce inflammation and discomfort.

Surgical Treatment

If symptoms are severe or persist despite conservative treatments, surgery may be recommended. Carpal tunnel release surgery involves cutting the transverse carpal ligament to relieve pressure on the median nerve. This can lead to significant symptom improvement, and in most cases, symptoms do not return.

If you suspect you have CTS, do not ignore the symptoms. Seeking medical advice early can prevent long-term nerve damage and loss of hand function. A doctor can guide you on the best treatment plan based on the severity of your symptoms.

Carpal tunnel syndrome is manageable, and in many cases, full function can be restored with the right treatment. Whether through lifestyle adjustments, therapy, or surgery, addressing CTS early can improve your quality of life. If you experience symptoms, consult a healthcare professional to determine the best course of action.