What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is a medical condition caused by the compression of the median nerve as it travels through the carpal tunnel, a narrow passageway in the wrist. This nerve is responsible for providing sensation to the thumb, index, middle, and part of the ring fingers, as well as for controlling some of the small muscles at the base of the thumb. When the median nerve is compressed, individuals may experience symptoms such as numbness, tingling, weakness, and pain in the affected hand and fingers. These symptoms often worsen at night and can be aggravated by activities that involve repetitive wrist movements. CTS is a common condition, particularly among people who perform repetitive tasks with their hands, such as typing, assembly line work, and various manual labor jobs.

 

Carpal Tunnel vs. Cubital Tunnel Syndrome

Carpal Tunnel Syndrome and Cubital Tunnel Syndrome are both nerve compression syndromes, but they affect different nerves and parts of the arm. While CTS involves the median nerve at the wrist, Cubital Tunnel Syndrome affects the ulnar nerve at the elbow. The ulnar nerve runs along the inner side of the arm and passes through the cubital tunnel, a narrow space at the elbow. Compression of the ulnar nerve can lead to symptoms such as numbness and tingling in the ring and little fingers, pain in the elbow, and weakness in the hand, particularly in the grip and fine motor skills. The primary difference between the two conditions lies in the location of the nerve compression and the specific areas of the hand that are affected.

 

Diagnosis

Diagnosing Carpal Tunnel Syndrome typically involves a combination of a patient’s medical history, physical examination, and diagnostic tests. During the physical exam, a doctor may perform specific maneuvers, such as the Tinel’s sign and Phalen’s test, to elicit symptoms of CTS. In Tinel’s sign, the doctor taps on the median nerve at the wrist to see if it causes tingling in the fingers. Phalen’s test involves flexing the wrist to see if it induces symptoms. Additionally, nerve conduction studies and electromyography (EMG) are often used to measure the electrical activity in the median nerve and the muscles it controls. These tests help confirm the diagnosis by indicating whether there is any slowing of nerve impulses or muscle damage.

 

Treatment

Treatment for Carpal Tunnel Syndrome varies depending on the severity of the condition. For mild to moderate cases, non-surgical options are usually recommended first. These may include wrist splinting, especially at night, to keep the wrist in a neutral position, and anti-inflammatory medications to reduce swelling and pain. Corticosteroid injections may also be used to provide temporary relief. Physical therapy exercises can help improve the strength and flexibility of the wrist and hand. If these conservative measures do not relieve the symptoms, or if the condition is severe, surgical intervention might be necessary. Carpal tunnel release surgery involves cutting the ligament that forms the roof of the carpal tunnel to relieve pressure on the median nerve. This procedure can be done through open surgery or endoscopic surgery, which uses a smaller incision and a camera to guide the surgeon. Recovery from surgery varies, but many patients experience significant improvement in their symptoms.