The carpal tunnel is a small tunnel made of bones and ligaments in the wrist. The median nerve runs down the forearm through the tunnel and into the hand on the palm side of the hand and provides feeling to the hand and fingers. Carpal tunnel syndrome or CTS is a painful and debilitating condition of the hand and arm caused due to pressure over the median nerve in wrist.The median nerve can become compromised from compression or inflammation under this tunnel, which leads to carpal tunnel syndrome.
The most common cause of CTS is repetitive motion.
Conditions like diabetes mellitus, pregnancy, hypothyroidism and obesity can predispose somebody to CTS.
Common symptoms include numbness and pain in the hand. This is typically worse at night and can awaken one from sleep. It is typically relieved by shaking the hand.
Other symptoms can be the tendency to drop things, difficulty manipulating small objects, and a burning sensation.
As the disease progresses there can be decreased sensation in the outer aspect of hand, muscle atrophy in the palm, and decreased hand strength and function.
History and Physical examinations can show evidence of CTS.
Neurophysicians at the Centre for Minimally Invasive Neurosurgery India would conduct nerve conduction studies (NCSs) and needle EMG to diagnose CTS. Nerve conduction studies measure electrical impulse speeds traveling through the nerve. T If a person has CTS, the speed of the impulse will decrease as it passes through the carpal tunnel. An EMG can also help diagnose CTS. Blood tests may be performed to rule out Hypothyroidism or diabetes mellitus
Treatment includes certain medications or analgesics, stretching exercises, immobilizing the wrist with the use of carpal tunnel splint especially at night and modifying activities.
In patients who do not respond to non surgical treatment or who are developing weakness and numbness merit surgery. Surgery is safe and effective in upto 95% cases. Its a day care surgery performed under the microscope with release of the median nerve.
The patient will have irreversible median nerve damage leading to intractable pain, permanent numbness and muscle weakness in the areas supplied by the median nerve.
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