It is a prevalent hand condition stemming from pressure on the median nerve within the wrist’s carpal tunnel. This pressure leads to various symptoms, including pain, numbness, tingling, and weakness in the hand and wrist. Causes can include broken wrists and other factors that increase pressure within the carpal tunnel. Understanding these causes and symptoms is crucial for diagnosis and management. Further exploration into treatment options, preventative measures, and the impact of CTS on daily activities would be beneficial.

Overview of Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) occurs when the median nerve, which runs from your forearm, through your wrist, into the palm of your hand, becomes pressed or squeezed at the wrist.

The median nerve and the tendons that bend the fingers pass through the carpal tunnel—a narrow, rigid tube of ligament and bones at the base of the hand. The median nerve provides feeling to the thumb, index, and middle finger, and part of the ring finger (but not the little finger). It also controls some small muscles at the base of the thumb.

Who Gets Carpal Tunnel Syndrome?

CTS is a common nerve condition.

Anyone can get CTS, but the condition usually occurs in adults. Women are more likely than men to get carpal tunnel syndrome.

Symptoms of Carpal Tunnel Syndrome

Symptoms usually start slowly, with numbness or tingling in the fingers, especially the thumb and the index and middle fingers. Symptoms often first appear in one or both hands at night but go away during the day. You may feel numbness, weakness, or tingling in your fingers. Your fingers may also feel swollen and cold. You might wake up and feel you need to “shake out” your hand or wrist.

As your symptoms get worse, you might feel symptoms during the day, especially with certain activities that require the use of your wrist and hand. These may include talking on the phone, reading a book or newspaper, or driving.

In chronic (long-term) or untreated cases, the fingers can feel numb all the time and you may have difficulty grabbing small objects, such as buttons and zippers. The muscles at the base of the thumb may also become so weak that it becomes difficult or impossible to grasp small objects.

Causes of Carpal Tunnel Syndrome

Researchers do not know the causes of carpal tunnel syndrome. The condition CTS may result from a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Sometimes, irritated tendons can thicken or swell, which can narrow the tunnel and compress the median nerve. In many cases, no single cause can be identified. Contributing factors may include the following:

Environmental Factors

• Trauma or injury to the wrist, such as a sprain or fracture, that causes swelling.

• Mechanical problems in the wrist joint.

• Repeated use of vibrating machinery.

• Medical Conditions

• Problems with the pituitary gland or the thyroid gland.

• Rheumatoid arthritis or other autoimmune diseases.

• Diabetes or other metabolic disorders that make the body’s nerves susceptible to compression.

• Fluid retention during pregnancy or menopause.

• Other

• Age: CTS usually occurs in adults.

• Sex: Women are more likely than men to develop CTS.

Risk factors

Several factors have been linked with carpal tunnel syndrome. Although they may not directly cause carpal tunnel syndrome, they may increase the risk of irritation or damage to the median nerve. These include:

Anatomical factors. A wrist fracture or dislocation can alter the space within the carpal tunnel. Arthritis that causes changes to the small bones in the wrist can affect the carpal tunnel. These changes can put pressure on the median nerve.

People who have smaller carpal tunnels may be more likely to have carpal tunnel syndrome.

Sex assigned at birth. Carpal tunnel syndrome is generally more common in women. This may be because the carpal tunnel area is relatively smaller in women than in men. Or it may be due to the effect of hormones on the lining of the tendons in the carpal tunnel.

Women who have carpal tunnel syndrome also may have smaller carpal tunnels than do women who don’t have the condition.

Nerve-damaging conditions. Some chronic illnesses, such as diabetes, increase the risk of nerve damage, including damage to the median nerve.

Inflammatory conditions. Rheumatoid arthritis, gout and other conditions that cause swelling, known as inflammation, can affect the lining around the tendons in the wrist. This can put pressure on the median nerve.

Medicines. Some studies have shown a link between carpal tunnel syndrome and anastrozole (Arimidex), a medicine used to treat breast cancer.

Obesity. Being obese is a risk factor for carpal tunnel syndrome.

Body fluid changes. Fluid retention may increase the pressure within the carpal tunnel, irritating the median nerve. This is common during pregnancy and menopause. Carpal tunnel syndrome that happens with pregnancy generally gets better on its own after pregnancy.

Other medical conditions. Certain conditions, such as thyroid disorders, kidney failure and lymphedema, may increase the chances of getting carpal tunnel syndrome.

Workplace factors. Working with vibrating tools or on an assembly line that requires repeated movements that flex the wrist may create pressure on the median nerve. Such work also may worsen existing nerve damage. Pressure on the nerve can be worse if the work is done in a cold environment.

However, the scientific evidence is conflicting and these factors haven’t been established as direct causes of carpal tunnel syndrome.

Several studies have evaluated whether there is a link between computer use and carpal tunnel syndrome. Some evidence suggests that mouse use, but not the use of a keyboard, may be related to carpal tunnel syndrome. There has not been enough quality and consistent evidence to support extensive computer use as a risk factor for carpal tunnel syndrome. However, computer use may cause a different form of hand pain.

Prevention

Sitting in front of the computer in the correct way to reduce stress on the hands and wrists.

There are no proven strategies to prevent carpal tunnel syndrome, but you can lessen stress on the hands and wrists with these methods:

Reduce your force and relax your grip. If your work involves a cash register or keyboard, for instance, hit the keys softly.

Take short, frequent breaks. Gently stretch and bend your hands and wrists periodically. Alternate tasks when possible. This is especially important if you use equipment that vibrates or that requires you to exert a great amount of force. Taking a break for even a few minutes each hour can make a difference.

Watch your form. Do not bend your wrist all the way up or down when using a keyboard. A relaxed middle position with the wrists parallel to the floor is best. Keep your keyboard at elbow height or slightly lower.

Improve your posture. The wrong posture can occur when you adjust your body to view a computer screen rather than adjusting the screen height and distance to a correct posture. The wrong posture rolls shoulders forward, shortens the neck and shoulder muscles, and compresses nerves in the neck. This can cause neck pain and also may bother the hands and arms.

Change your computer mouse. Make sure that your computer mouse is comfortable to use and doesn’t strain your wrist.

Keep your hands warm. You’re more likely to develop hand pain and stiffness if you work in a cold environment. If you can’t control the temperature at work, put on fingerless gloves that keep the hands and wrists warm.

In cases that do not respond to conservative treatment, surgical removal can be performed safely and smoothly.