What is Carpal Tunnel Syndrome?
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Carpal Tunnel Syndrome (CTS) is a condition that affects the wrist and hand, causing numbness, tingling, and weakness. CTS is a common disorder. The estimated prevalence of CTS in the general population is between 1 and 5 percent. CTS is more frequent in females, with a female-to-male ratio of approximately 3 to 1. It is caused by the compression of the median nerve, which runs from the forearm into the hand, in the narrow passageway known as the carpal tunnel. CTS is often seen in people who engage in repetitive motions with their hands and wrists, such as typing, using a mouse, or performing manual labor. Some patients report temporary improvement in symptoms by shaking or wringing their hands or by placing them under warm running water.
Prevention: To reduce the risk of developing CTS, it's important to adopt healthy habits and techniques to reduce stress on the wrist and hand. This includes practicing good posture, taking frequent breaks, and avoiding repetitive motions. Wearing wrist braces or ergonomic equipment can also help reduce the strain on the wrist and prevent the development of CTS. For example, a wrist splint can keep the wrist in a neutral position, reducing pressure on the median nerve. Another option is a wrist brace with a built-in support bar, which can help reduce strain on the wrist during repetitive motions. Additionally, incorporating wrist and hand stretches into your daily routine can help improve circulation, reduce tension, and prevent the onset of CTS.
Diagnosis: The diagnosis of CTS typically involves a combination of a patient's symptoms, physical examination, and nerve conduction studies. During a physical examination, a doctor may assess your grip strength, test your reflexes, and check for sensitivity or tenderness in your wrist. They may also perform the Tinel's sign test, which involves tapping the median nerve to see if it causes tingling in the fingers, or the Phalen's sign test, which involves holding your wrist in a flexed position to see if it causes numbness or tingling in the fingers. The manual carpal compression, or Durkan test is performed by applying pressure over the transverse carpal ligament for 30 seconds. Pain or paresthesia indicates a positive result.?Nerve conduction studies involve using small electrodes to measure the speed and strength of electrical signals in the median nerve. An electromyogram (EMG) may also be performed to determine the extent of nerve damage.
Treatment: The goal of treatment for CTS is to relieve pressure on the median nerve and reduce symptoms. Conservative treatments such as rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy can often relieve the symptoms of CTS. Physical therapy may include wrist and hand exercises to improve flexibility, strength, and circulation. Some specific physical therapy treatments for CTS include:
In more severe cases, surgical intervention may be required to relieve pressure on the median nerve. 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 relieve pressure on the median nerve.
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Corticosteroid injections are another treatment option for CTS, and evidence suggests they can be an effective form of treatment. Corticosteroids are anti-inflammatory medications that can help reduce inflammation and swelling around the median nerve, reducing symptoms of CTS. In a study published in the Journal of Hand Surgery, patients who received corticosteroid injections reported significant improvement in their symptoms compared to patients who received placebo injections. Another study, published in the Journal of Bone and Joint Surgery, found that corticosteroid injections were effective in relieving symptoms of CTS for up to 12 weeks.
Surgical intervention for CTS is typically indicated when conservative treatments are ineffective or when symptoms are severe and interfere with daily activities. Some specific indications for surgery include persistent and severe pain, persistent numbness, loss of hand strength, or atrophy (shrinking) of the muscles in the hand.
After surgical treatment, physical therapy is often recommended to help restore strength and mobility to the wrist and hand. Additionally, post-operative care may include the use of wrist splints, therapy, and other modalities to promote proper healing and recovery. Wrist braces can also be helpful in preventing further damage to the wrist and supporting proper alignment during the healing process. For example, a custom wrist brace can be designed to fit the individual's wrist and provide the exact level of support needed during recovery. A wrist brace with adjustable compression can also be useful to control swelling and support the wrist as it heals.
In conclusion, Carpal Tunnel Syndrome is a common condition that affects the wrist and hand, causing numbness, tingling, and weakness. With proper treatment and care, CTS can be managed, and patients can go on to live pain-free, productive lives. Wrist braces, physical therapy, corticosteroid injections, and in severe cases, surgery, are some of the most effective ways to manage CTS. If you are experiencing symptoms of CTS, it is important to seek the help of a healthcare professional for a proper diagnosis and treatment plan.
Contact us at upswinghealth.com for further advice and chat with one of our orthopedic professionals.