Nervous System

Carpal Tunnel Syndrome
Carpal tunnel syndrome:
It is a common condition that causes numbness, tingling, and pain in the hand and forearm. This condition occurs when one of the hand's main nerves (the median nerve) is compressed as it passes through the wrist.

Median nerve:
The median nerve and the tendons that flex the fingers pass through the carpal tunnel, a narrow, rigid passage of ligaments and bones at the base of the hand. It provides sensation to the thumb, index finger, middle finger, and half of the ring finger (the half toward the thumb), and it also controls some of the small muscles at the base of the thumb.

Symptoms usually begin gradually with frequent numbness or tingling in the fingers, especially the thumb, index finger, and middle finger. Symptoms often first appear in one or both hands during the night. Early symptoms include:
  • Numbness.
  • Feeling swollen fingers.
  • A tingling sensation or pain in the fingers.
As symptoms worsen, the following may be observed:
  • Tingling during the day, especially with certain activities (such as: talking on the phone, reading a book or newspaper, or driving a car).
  • Mild to severe pain, sometimes worse at night.
  • Loss of some movement in the hand.
  • Hand weakness may make it difficult to hold small objects or perform other manual tasks.
In chronic and/or untreated cases, the muscles at the base of the thumb may weaken and atrophy, and some people with severe carpal tunnel syndrome cannot distinguish between heat and cold by touch, which may cause their fingertips to burn without feeling it.

Risk factors:
Carpal tunnel syndrome is often a result of 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 a single cause cannot be identified, and the contributing factors may include:
  • Gender: Women are three times more likely to develop carpal tunnel syndrome than men.
  • Repetitive use of the hand and repetition of the same hand and wrist movements or activities over a long period of time.
  • Hand and wrist position and activities that involve extreme flexion or extension of the hand and wrist for a long period of time.
  • Frequent sleeping on a bent wrist.
  • Suffering from a wrist injury that causes swelling (such as a sprain or fracture).
  • Rheumatoid arthritis or other joint diseases.
  • Pregnancy and hormonal changes during pregnancy.
  • Fluid retention during pregnancy or menopause.
  • The appearance of a cyst or tumor in the carpal tunnel.
  • - Having diabetes or other metabolic disorders that directly affect the body’s nerves and make them more vulnerable to stress.
  • An imbalance in the pituitary gland or thyroid gland.
  • Frequent use of vibrating hand tools.​
Treatment should begin as soon as possible under the supervision of a doctor, and the underlying causes (such as diabetes or arthritis) should be treated first.
Non-surgical treatments:
  • Splint (brace): Initial treatment is usually a splint worn at night.
  • Avoid daytime activities that may trigger symptoms, but if the discomfort is minor, you should take frequent breaks from tasks to rest the hand.
  • When the wrist is red and swollen, cold compresses can be used.
  • Medications to relieve pain and swelling. Nonsteroidal anti-inflammatory drugs (such as ibuprofen) and other pain relievers may provide some relief.
  • Medications medically prescribed, where corticosteroids can be injected directly into the wrist or taken orally; To relieve pressure on the median nerve.
  • Practice hand exercises that may help relieve pain.
Surgery: It may be recommended when non-surgical treatments are ineffective or if the disorder becomes severe.

Instructions for those with carpal tunnel:
  • Keep the wrist straight while resting or sleeping at night; To prevent pressure on the nerve and carpal tunnel.
  • Use tools that help keep the wrist in a moderate position instead of bending it repeatedly.
  • Wear fingerless gloves to help keep hands warm and flexible.
  • In the workplace, appropriate adjustments can be made that help rest the wrist and keep it in the correct position (such as: adjusting the sitting position by raising or lowering the chair or moving the keyboard in a way that makes the wrist comfortable when typing on it).
  • Take periodic breaks to rest the hand and do stretching exercises.

Last Update : 15 October 2023 10:41 AM
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