Carpal Tunnel Syndrome

Carpal tunnel syndrome is characterised by pain, burning / tingling sensation, numbness at the wrist, palm, thumb, index, middle & adjoining half of ring finger. It is caused by entrapment of the median nerve in a tunnel, called Carpal tunnel. Entrapment is caused by the inflammation of the synovial sheath covering flexor tendons at the wrist.

Pain, tingling and numbness in fingers are typically present on waking up or can wake the patient.

The fingers feel swollen and intense aching is felt in the forearm.

The symptoms may appear when the patient holds a newspaper

Or the steering wheel of a car or holding objects in kitchen. Permanent numbness and wasting of the thinnear eminence cause clumsiness of movements. It may lead to depression.

Sometimes it is seen in the third trimester of pregnancy which settles down of its own after delivery.

Tests and investigations — tapping the median nerve in

The carpal tunnel or holding the wrist in forced

Flexion may provoke symptoms.

 Weakness of grip of hand is also suggestive of the condition.

 The carpal tunnel syndrome can be confirmed by US, MRI & CT scan. But they are usually not needed.

Management and injection technique — A splint worn on the wrist

at night relieves or reduces the symptoms of carpal tunnel syndrome.

This is diagnostic and may be curative.

Anti inflammatory & neurotropic drugs help in recovery.

 A corticosteroid injection into the carpal tunnel may also be considered,

This often helps rapidly, although recurrence is common.

Surgical decompression of the median nerve is usually a permanent solution.