Have you been feeling a bit clumsy in your hands? Do you feel like your hands and wrists are always numb, tingly or in pain? Does your everyday work involve a lot of hand and wrist movements? Chances are you could be another victim of carpal tunnel syndrome.
Limited to fingers, hands, and wrist, the symptoms of carpal tunnel syndrome (CTS) can be extremely uncomfortable and almost unbearable for many. For many, they can make the smallest tasks, like opening a jar or grasping a pen, extremely difficult and painful. The worst thing about CTS is that if unchecked, the symptoms gradually worsen and impair hand and wrist motion even more. Fortunately, treatment is possible and involves medical, surgical, and home-based remedies.
An Overview of Carpal Tunnel Syndrome
Carpal tunnel syndrome describes a condition affecting the median nerve, one of the primary nerves that run through the wrist to your fingers. Through its course, it passes through a carpal tunnel, a space formed by naturally arching wrist bones. The roof of this tunnel is formed by a thick band known as the transverse carpal ligament. With a solid roof and walls, the size of this tunnel remains fixed and cannot change under any circumstances. In addition to the median nerve, nine tendons that bend your thumbs and fingers pass through the tunnel.
Carpal tunnel syndrome happens when the median nerve gets trapped in this tunnel for various reasons, such as excessive work or pressure on the wrist. Because the median nerve provides sensation to the skin covering the index and middle fingers, thumb, and half of the ring finger, these areas may become symptomatic.
The symptoms of carpal tunnel syndrome are prominent in the areas where the median nerve innervates. These areas include the thumb, index and middle finger, and a part of the ring finger. Some common symptoms of CTS include the following:
- Burning or pain
- Tingly or pins and needles sensations
- A weaker grip
Many people develop CTS in one hand, but it is equally possible to experience it bilaterally in both wrists. The symptoms are first localized to the wrist and slowly begin to affect the whole hand. They might occur at any time but are particularly worse at night and can sometimes get so severe that they may keep you up. Shaking the wrist or changing its position can cause temporary relief.
What Causes Carpal Tunnel Syndrome?
Extra pressure on the median nerve at the wrist is the most common cause of carpal tunnel syndrome. Sometimes, this extra pressure occurs due to inflammation or swelling inside the tunnel, leading to a condition called compressive neuropathy. Some conditions known to cause compressive neuropathy and CTS include the following:
- Psoriatic arthritis
- Rheumatoid arthritis
- Wrist fractures
- Ganglion cysts
- Arthritic spurs in carpal bones
Sometimes, simple activities like bending a wrist or making a fist for a long time can increase the pressure on the median nerve, triggering CTS. In many circumstances, a constant bend or fist, such as during sleep or reading a book, causes temporary tingly feelings in the fingers which usually go away as you move your fingers back and forth. However, when it starts happening more frequently, the risk of developing carpal tunnel syndrome greatly increases.
Engaging in repetitive activities at work involving forceful gripping or vibration also increases the risk of acquiring CTS symptoms. However, experts are unsure whether these activities trigger the condition or only exacerbate its pre-existing symptoms. Pinpointing the cause of carpal tunnel syndrome can be difficult and requires experience and specialist care.
The presence of certain risk factors increases the chances of acquiring CTS. For instance, females are more likely to experience the condition than men. Other factors like aging increase its risk which is why older people over the age of 40 years are more likely to acquire it than children and adolescents. Similarly, CTS is more common in people with certain medical conditions, including hypothyroidism, fibromyalgia, alcohol addiction, diabetes, and obesity. Lastly, the hormonal changes and excessive fluid retention in pregnancy also add to the risk.
Managing Carpal Tunnel Syndrome: The Medical and Surgical Ways
There are plenty of ways to manage carpal tunnel syndrome. Most doctors begin with oral and injectable medications and keep surgical intervention as a last resort.
The main goal of medical treatment is to remove or reduce the potential causes of increased pressure on the median nerve. As the pressure releases, the symptoms automatically subside. Following are some commonly prescribed medical ways for CTS management:
- Oral anti-inflammatory medicine to reduce the swelling and pressure
- Steroid injection to decrease inflammation and release pressure
- Wrist splints for support
Oral medicines and injections are more likely to work when symptoms are short-lived and relatively new. Doctors also recommend wearing wrist splints, particularly at night to avoid bending. These splints are more successful in people whose CTS symptoms are secondary to wrong wrist or hand movements or position and are mild to moderate. However, remember that splints alone cannot cure the condition.
While many people respond to medical management of carpal tunnel syndrome, many remain resistant. For such people, surgical intervention is the most effective treatment to pursue. Experts can use different surgical techniques to cut the transverse carpal ligament and release the extra pressure off the median nerve. As the tunnel roof splits up, it adds more room for the nerve and tendons to pass through the tunnel without too much congestion. The results are almost immediate in most cases.
Keeping Carpal Tunnel Syndrome in Check: What You Can Do At Home
Tired of your carpal tunnel syndrome symptoms bothering you day and night, but don’t want to go to the doctor just yet? There are plenty of things you can try at home and see if your problem responds. For this purpose, keep the following tips in mind.
#1 - Give your wrist a break
In the majority of people, carpal tunnel syndrome is a consequence of repetitive wrist or hand movements, such as knitting, playing video games, typing, weightlifting, or yoga. It is imperative to identify which of your usual activities exacerbate the symptoms and give it a break. If you cannot stop it, consider reducing it or doing it in breaks. Breaks will allow your wrist and hand to rest enough so that your symptoms get under control and you can continue with your normal routine without any pain.
#2 - Try a wrist-hand orthotic
Also known as a wrist brace or splint, a wrist-hand orthotic can help keep your wrist stabilized in a well-aligned position. Consider choosing one that is firm, immobilizing, and structured. A soft, flexible variant will not likely do much for your problem. Remember to wear the splint while engaging in wrist-intensive tasks to keep the hands well-supported. You may also wear it to sleep if you suspect your abnormal sleep posture worsens your symptoms.
#3 - Adopt a more ergonomic routine
As you invest in a good orthotic to stabilize your wrist in a neutral position, try making the rest of your routine more ergonomic as well. For instance, if your job involves sitting at a desk and typing all day, why not make your workstation more convenient for your wrists? What you need to focus on is keeping your wrist straight instead of in a flexed or extended position. To ensure this, adjust the position of your mouse and keyboard and ensure that your chair height compliments the setting.
#4 - Ease the inflammation with an ice pack
Tendon inflammation can heavily pressurize your median nerve and trigger CTS pain. If your wrist becomes warm, swollen, and red following an intensive activity period, try bringing down the inflammation using cold therapy. Wrap your affected hand and wrist with a towel and slide it into a ice bucket. Allow your wrist to soak for fifteen minutes, and repeat the process a few times daily. Ice packs also work like magic to keep the inflammatory levels down and can greatly help with symptomatic CTS management.
#5 -Keep your hands warm
Cold is also a trigger for carpal tunnel syndrome in many people. Exposure to cold conditions can stiffen the muscles and joints, which exacerbates the pain and tingling at the wrist. So if you feel like your hands are always cold or your work environment is generally a bit chilly, consider trying fingerless gloves. These gloves can keep your joints warm without interrupting your work and save you from the extra hassle of CTS. You may also consider trying water therapy, where you immerse your affected hand in warm water for a few minutes up to four times a day. Make sure to gently move all your fingers and wrists while immersed in water.
#6 - See an occupational therapist
An occupational therapist can teach easy exercises to strengthen and stretch your wrist and hand muscles. Moreover, you can also learn how to change your routine hand movements so that they do not put pressure or stress on your median nerve and keep carpal tunnel syndrome at bay.
Carpal tunnel syndrome is highly disruptive and painful, especially if it remains unchecked for a long time. If you have been experiencing its characteristic symptoms for a long time despite following all home remedies, consider meeting with a doctor and asking about other ways to relieve the pressure and pain. More invasive treatments, such as steroid injections or surgery, might be indicated in resistant cases to prevent permanent nerve damage.