Carpal Tunnel Syndrome

By Jeanette Calara, PT, DPT, MBA, OCS, COMT, GCFP, COS-C 

Carpal tunnel syndrome is possibly the common nerve disorder today. Middle-aged to older individuals are more likely to develop the syndrome than younger persons, and females three times more frequently than males. 

Carpal tunnel syndrome result as the median nerve is compressed as it travels through the wrist, quite often by swollen tissues, blocking or slowing nerve impulses from travelling through the nerve. This condition brings about symptoms from mild occasional numbness to hand weakness, loss of feeling and loss of hand function.

Most of the time, it affects one hand though, it is quite possible to affect both at the same time, causing symptoms in the thumb and the index, middle and ring fingers.often a tingling sensation or burning of the hand which may radiate to the forearm.The symptoms are often experienced in the morning Symptoms can interfere with activities such as driving, holding a book or other repetitive activity with the hands, especially activities that require a person to grasp something for long periods of time or bend their wrist. Activities of daily living such as buttoning a shirt may become challenging. 

As the condition progress to a persistent numbness and burning as in the case of chronic carpal tunnel syndrome, a loss of muscle mass occurs at the base of the thumb on the palm side of the hand and when untreated, hand weakness, impaired use of the hand, and loss of sensation in their hand is experienced as a result of permanent nerve and muscle damage.
Carpal tunnel syndrome occurs commonly in patients that are pregnant, overweight or have pre-existing conditions such as thyroid disease, diabetes or arthritis, or injuries such as wrist fractures. 

Diagnosis of carpal tunnel syndrome based on identification of accurate symptoms, weakness of the muscles innervated by the median nerve, decreased sensation in the hand , Phalen test, Tinel Sign, nerve conduction test, diagnosic ultrasonography and MRI. 

Carpal tunnel syndrome can be treated effectively with medications, splinting, physical therapy and steroid injections in the wrist to surgery, known as a carpal tunnel release.