Carpal Tunnel Syndrome (CTS) is a common condition that affects the hands and wrists, causing pain, numbness, and tingling sensations. It's a result of pressure on the median nerve, which controls sensations and movements in the thumb and first three fingers. While CTS can develop over time, it's important to understand the causes, symptoms, and treatment options available to help manage and alleviate its effects.

What Is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway in the wrist that houses the median nerve and tendons responsible for moving the fingers. When this tunnel becomes compressed, the pressure on the median nerve can result in a range of uncomfortable and debilitating symptoms. CTS is often associated with repetitive hand movements, particularly those involving the wrist in flexion or extension, but it can also be linked to other factors, including underlying health conditions [Wipperman & Penny, 2024; Wipperman & Goerl, 2016; Malakootian et al, 2023].

What are the Causes of Carpal Tunnel Syndrome?

Several factors contribute to the development of CTS, including:

1. Repetitive Movements: One of the most common causes of CTS is repetitive hand and wrist movements, such as typing, using a mouse, or working on an assembly line. Over time, these movements can place strain on the tendons and compress the median nerve.
2. Workplace Factors: Jobs that involve frequent use of vibrating tools, forceful gripping, or prolonged hand/wrist positioning can increase the risk of developing CTS [Jackson et al, 2018; Barcenilla et al, 2012; Mattioli et al, 2009; Viikari-Juntura & Silverstein, 1999].
3. Health Conditions: Certain medical conditions, like diabetes, rheumatoid arthritis, or obesity, can contribute to the development of CTS by affecting nerve health or causing inflammation [Stevens et al, 1992; Yang et al, 2022; Balci & Utku, 2007; Karpitskaya et al, 2002].
4. Pregnancy: Hormonal changes during pregnancy can lead to fluid retention, which may increase pressure in the carpal tunnel.
5. Anatomical Factors: Some people have a naturally narrower carpal tunnel, which can make them more susceptible to CTS.

What are the Symptoms of Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome can manifest in various ways, and symptoms often start gradually. Common signs include:

What are the Treatment Options for Carpal Tunnel Syndrome?

If you suspect you have CTS, it’s essential to seek medical advice early on to prevent further damage to the median nerve. There are several treatment options available, depending on the severity of the condition:

1. Non-Surgical Treatments

• Wrist Splints: Wearing a splint at night can help keep the wrist in a neutral position, reducing pressure on the median nerve [Wipperman & Penny, 2024; Wipperman & Goerl, 2016].
• Activity Modification: Take breaks during repetitive tasks to rest your hands and wrists. Ergonomic adjustments, like using a keyboard with proper wrist positioning, can also help prevent further strain.
• Physical Therapy: A physical therapist can provide exercises and stretches to strengthen the wrist and improve flexibility [Wipperman & Goerl, 2016; Karjalanen et al, 2022].
  
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen or aspirin can help reduce inflammation and alleviate pain.
• Corticosteroid Injections: If other treatments don’t work, a corticosteroid injection into the carpal tunnel may reduce inflammation and relieve symptoms [Wipperman & Penny, 2024; Wipperman & Goerl, 2016; Mooar et al, 2018].

2. Surgical Treatment

In severe cases of CTS, or when conservative treatments fail to provide relief, surgery may be necessary. The most common surgical procedure for CTS is called carpal tunnel release, which involves cutting the ligament that forms the roof of the carpal tunnel to reduce pressure on the median nerve.

• Open and Endoscopic Releases: Traditionally surgery is performed using either through an open surgery or with minimally invasive techniques using a small incision.

Final Thoughts

Carpal Tunnel Syndrome is a condition that affects millions of people worldwide, but with early intervention and proper management, most individuals can find relief. If you're experiencing any symptoms of CTS, it’s important to seek professional advice to determine the best course of action. With the right treatment plan, you can alleviate pain, improve function, and prevent the condition from progressing.

Schedule a consultation at:

(781) 591-7855

info@BSBortho.com

20 Walnut St

Suite 14

Wellesley MA 02481

References:

1. Balci K, Utku U. Carpal tunnel syndrome and metabolic syndrome. Acta Neurol Scand. 2007 Aug;116(2):113-7.
   
2. Barcenilla A, March LM, Chen JS, Sambrook PN. Carpal tunnel syndrome and its relationship to occupation: a meta-analysis. Rheumatology (Oxford). 2012 Feb;51(2):250-61.
   
3. Jackson R, Beckman J, Frederick M, Musolin K, Harrison R. Rates of Carpal Tunnel Syndrome in a State Workers' Compensation Information System, by Industry and Occupation - California, 2007-2014. MMWR Morb Mortal Wkly Rep. 2018 Oct 5;67(39):1094-1097.
   
4. Karjalanen T, Raatikainen S, Jaatinen K, Lusa V. Update on Efficacy of Conservative Treatments for Carpal Tunnel Syndrome. J Clin Med. 2022 Feb 11;11(4):950.
   
5. Karpitskaya Y, Novak CB, Mackinnon SE. Prevalence of smoking, obesity, diabetes mellitus, and thyroid disease in patients with carpal tunnel syndrome. Ann Plast Surg. 2002 Mar;48(3):269-73.
   
6. Malakootian M, Soveizi M, Gholipour A, Oveisee M. Pathophysiology, Diagnosis, Treatment, and Genetics of Carpal Tunnel Syndrome: A Review. Cell Mol Neurobiol. 2023 Jul;43(5):1817-1831.
7. Mattioli S, Baldasseroni A, Bovenzi M, Curti S, Cooke RM, Campo G, Barbieri PG, Ghersi R, Broccoli M, Cancellieri MP,Colao AM, Dell'omo M, Fateh-Moghadam P, Franceschini F, Fucksia S, Galli P, Gobba F, Lucchini R, Mandes A, Marras T, Sgarrella C, Borghesi S, Fierro M, Zanardi F, Mancini G, Violante FS. Risk factors for operated carpal tunnel syndrome: a multicenter population-based case-control study. BMC Public Health. 2009 Sep 16;9:343.
   
8. Mooar PA, Doherty WJ, Murray JN, Pezold R, Sevarino KS. Management of Carpal Tunnel Syndrome. J Am Acad Orthop Surg. 2018 Mar 15;26(6):e128-e130.
   
9. Nora DB, Becker J, Ehlers JA, Gomes I. What symptoms are truly caused by median nerve compression in carpal tunnel syndrome? Clin Neurophysiol. 2005 Feb;116(2):275-83.
   
10. Sternbach G. The carpal tunnel syndrome. J Emerg Med. 1999 May-Jun;17(3):519-23.
    
11. Stevens JC, Beard CM, O'Fallon WM, Kurland LT. Conditions associated with carpal tunnel syndrome. Mayo Clin Proc. 1992 Jun;67(6):541-8.
    
12. Viikari-Juntura E, Silverstein B. Role of physical load factors in carpal tunnel syndrome. Scand J Work Environ Health. 1999 Jun;25(3):163-85.
    
13. Wipperman J, Penny ML. Carpal Tunnel Syndrome: Rapid Evidence Review. Am Fam Physician. 2024 Jul;110(1):52-57.
    
14. Wipperman J, Goerl K. Carpal Tunnel Syndrome: Diagnosis and Management. Am Fam Physician. 2016 Dec 15;94(12):993-999.
15. Yang C, Chen HH, Lee MC, Kao HK, Lin YT, Chen CT, Chang CJ, Tsai CH. Risk Factors of Carpal Tunnel Syndrome in Taiwan: A Population-Based Cohort Study. Ann Plast Surg. 2022 Jan 1;88(1):74-78.