Carpal Tunnel: What is it and How to Treat it

Carpal tunnel syndrome affects a large number of people around the world. More common in those with jobs that involve repetitive motions, such as typing, this problem can be irritating and painful to deal with. Carpal tunnel syndrome causes feelings of tingling in the fingers, with numbness and potentially pain in the hands and fingers. These feelings develop over time, and feel particularly strong at night. Normally, the numbness or the pain is felt the most strongly in the thumb, index finger and middle finger. Sufferers can also experience pins and needles and a weakness in finger and thumb strength.

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome is caused by a compression in the wrist, where pressure is put on one of the nerves that relays sensations in the hands and fingers. This nerve is called the median nerve. It runs through the narrowest part of the wrist, which contains smaller bones and a circular band of tissue used to contain the tendons that move the fingers. The nerve is compressed by a tightening of this band, and relief can only be found in some cases through surgery.

There are some potential causes for this compression of the median nerve. It can be caused by a history of carpal tunnel syndrome in the family, which can indicate a genetic wrist weakness. It can also be caused by injuries to the wrist, and also by pregnancy - up to half of all pregnant people develop carpal tunnel syndrome at some stage of their pregnancy. Other underlying issues, such as diabetes or arthritis, can exacerbate the issue, as can any work that involves repetitive hand gestures.

Treatment Options and Outcomes

In terms of care, orthopedic surgeons can help in the worst cases of carpal tunnel syndrome, for which surgery is needed. Often the syndrome disappears by itself, or with time and rest. If non-surgical treatments do not work, then surgery is the only other option and has to be considered. Permanent damage to the nerve can occur if steps are not taken in due course. This will then have an impact on the future function of the hand in question.

Your orthopedic surgeon can relieve the symptoms by dividing the flexor retinaculum, the band of tissue surrounding the nerves. Cutting this band in two and making the patient rest allows the body to heal the band. This puts less pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome.

Surgery is likely to fix the problem, though over time the symptoms may return. Generally, if the symptoms do return, it is with less force than at first. Talking to your orthopedic surgeon about your options is best before taking any action. If rest and other methods of relieving the symptoms, such as steroid injections, do not appear to alleviate the problem, then your orthopedic surgeon can guide you as to the best course of surgical action.

Carpal Tunnel or RSI?

There is often some confusion among patients as to whether carpal tunnel syndrome is the same as a repetitive strain injury (RSI). It is worth noting that they are two different conditions and should always be treated as such. An RSI occurs when a large amount of stress is placed on a certain part of the body. This stress will generally be the result of a consistent strain in the same area over time. Carpal tunnel syndrome may develop as a result of a repetitive strain injury but is just one type of this category of injury. To put it simply, an RSI is the cause of the problem, whereas carpal tunnel syndrome is the effect.

Preventing an RSI

People who work office jobs on computers are particularly prone to developing an RSI due to the repetitive nature of their work. However, certain sports and other activities, such as playing an instrument, are also known to be harmful in a similar way. Essentially, any action that requires the body to use the same part of their body for a repetitive movement over an extended period of time can contribute to this type of injury.

Making an effort to avoid repetitive movements, whether at work or throughout every other aspect of your life, is an optimum way to help to avoid these issues. However, doing so is not always practical. For this reason it is a good idea to find ways to mitigate the risk and alleviate the potential for a problem to arise. For example, there is much that can be done in the present day to customise your workstation in order to make it more ergonomic and comfortable. You can also make a conscious effort to stretch your body and your muscles at regular intervals throughout your day in order to break up any repetitiveness in your movements. Pay particular attention to your hands and wrists as this is where problems with this type of injury are prevalent. 

References

1) http://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome-topic-overview

2) http://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/basics/definition/con-20030332

3) http://patient.info/health/repetitive-strain-injury-leaflet