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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Carpal Tunnel Syndrome
What is carpal tunnel syndrome?
Carpal tunnel syndrome is a common, painful disorder of the
wrist and hand.
How does it occur?
Carpal tunnel syndrome is caused by pressure on the median
nerve in your wrist. People who use their hands and wrists
repeatedly in the same way (for example, illustrators,
carpenters, and assembly-line workers) tend to develop
carpal tunnel syndrome.
Pressure on the nerve may also be caused by a fracture or
other injury, which may cause inflammation and swelling. In
addition, pressure may be caused by inflammation and
swelling associated with arthritis, diabetes, and
hypothyroidism. Carpal tunnel syndrome can also occur
during pregnancy.
What are the symptoms?
The symptoms include:
- pain, numbness, or tingling in your hand and wrist,
especially in the thumb and index and middle fingers;
pain may radiate up into the forearm
- increased pain with increased use of your hand, such as
when you are driving or reading the newspaper
- increased pain at night
- weak grip and tendency to drop objects held in the hand
- sensitivity to cold
- muscle deterioration especially in the thumb (in later
stages).
How is it diagnosed?
Your health care provider will review your symptoms, examine
you, and discuss the ways you use your hands. He or she may
also do the following tests:
- Your provider may tap the inside middle of your wrist
over the median nerve. You may feel pain or a sensation
like an electric shock.
- You may be asked to bend your wrist down for one minute
to see if this causes symptoms.
- Your provider may arrange to test the response of your
nerves and muscles to electrical stimulation.
How is it treated?
If you have a disease that is causing carpal tunnel syndrome
(such as rheumatoid arthritis), treatment of the disease may
relieve your symptoms.
Other treatment focuses on relieving irritation and pressure
on the nerve in your wrist. To relieve pressure your health
care provider may suggest:
- restricting use of your hand or changing the way you use
it
- wearing a wrist splint
- exercises.
Your provider may prescribe an oral cortisonelike medicine or
a nonsteroidal anti-inflammatory medicine, such as
ibuprofen. He or she may recommend an injection of a
cortisonelike medicine into the carpal tunnel area. In some
cases surgery may be necessary.
How long will the effects last?
How long the symptoms of carpal tunnel syndrome last depends
on the cause and your response to treatment. Sometimes the
symptoms disappear without any treatment, or they may be
relieved by nonsurgical treatment. Surgery may be necessary
to relieve the symptoms if they do not respond to treatment
or they get worse. Surgery usually relieves the symptoms,
especially if there is no permanent damage to the nerve.
Symptoms of carpal tunnel syndrome that occur during
pregnancy usually disappear following delivery.
How can I take care of myself?
Follow your health care provider's recommendations. Also
try the following:
- Elevate your arm with pillows when you lie down.
- Avoid activities that overuse your hand.
- Find a different way to use your hand by using another
tool or try to use the other hand.
- Avoid bending your wrists.
What can I do to help prevent carpal tunnel syndrome?
If you do very repetitive work with your hands, make sure
that your hands and wrists are comfortable when you are
using them. Take regular breaks from the repetitive motion.
Avoid resting your wrists on hard or ridged surfaces for
prolonged periods.
If you have a disease that is associated with carpal tunnel
syndrome, effective treatment of the disease might help
prevent this condition.
In some cases the cause is not known and carpal tunnel
syndrome cannot be prevented.
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