Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is a syndrome in which the median nerve of your arm is being pressed in the carpal tunnel of your wrist. This can produce, among other symptoms, pain and paresthesia. Paresthesia being a pricking, burning, numb, or tingling sensation on your skin sometimes known as the “pins and needles” feeling. The most prominent symptoms of Carpal Tunnel Syndrome are periods of numbness in the thumb, index, and part of the ring finger. The periods of numbness usually occur at night which is thought to be due to the fact that people tend to sleep with their wrists flexed, which causes the carpal tunnel to decrease in size and thus cause compression of the median nerve. The numbness caused by Carpal Tunnel Syndrome is routinely so intense that it causes sufferers to wake up when sleeping. Carpal Tunnel Syndrome has long been thought to be caused mostly, if not completely, by repetitive movements such as typing. Recent research by Lozano-Calderón cites that genetics have a larger role in causing Carpal Tunnel Syndrome than movement of the wrists and hands. Someone who has Carpal Tunnel Syndrome for a long time, especially if the Carpal Tunnel Syndrome is left untreated, usually leads to permanent nerve damage. This can cause constant numbness, atrophy of some of the muscles at the base of the thumb, and weak palmar abduction.
Diagnosing Carpal Tunnel Syndrome
Many people believe that they have Carpal Tunnel Syndrome when in reality they usually have some other condition. The standard in diagnosing Carpal Tunnel Syndrome is through the use of electrophysiological testing. These tests generally measure the conductivity and the speed of conduction of the median nerve in comparison to other nerves supplying the hand or to different parts of the median nerve itself. If the conduction speed in the median nerve is slower than other nerves supplying the hand then it can be a sign of Carpal Tunnel Syndrome. More specifically the speed of conduction in the nerve can be compared at different parts of itself. If the conduction is slower in the part of the median nerve running through the carpal tunnel than the conduction speed through parts of the nerve not running through the carpal tunnel then it can be a sign of myelin sheath damage in the segment that runs through the carpal tunnel. This can indicate that the median nerve is being compressed in the region that runs through the carpal tunnel which is the cause of Carpal Tunnel Syndrome.
Using braces that go around the wrist that keep it immobilized was the recommended initial treatment for Carpal Tunnel Syndrome, but now it is recommended to instead modify your activities so that you minimize the Carpal Tunnel Syndrome causing movements and a regimen of non-steroidal anti-inflammatory drugs. It is recommended that this be followed by more aggressive options and/or referral to a specialist if symptoms don’t show signs of improvement. There are health professionals that recommend wear a wrist brace at night and during activities that cause stress on the wrists in addition to activity modification and anti-inflammatory drugs. Massage therapy techniques have been shown to alleviate pain and long-term symptoms with regular application as well.