Carpal tunnel syndrome and its symptoms

November 12, 2012

Carpal tunnel syndrome and its symptoms

It probably isn’t pins and needles, so you should see your GP!

If you regularly wake up in the middle of the night frantically shaking your hand and arm you may well be developing carpal tunnel syndrome. Of course this night-time shaking isn’t the only symptom of this condition but, it is one reported by many patients.

Carpal tunnel syndrome is the result of inflammation affecting the median nerve which runs through the forearm into the hand and fingers passing through the carpal tunnel, housing the carpal ligament, in the wrist. This inflammation may be the result of repetitive strain injury, changes to hormones (as occurs in pregnancy and the menopause for example), obesity, arthritis, an under active thyroid or there may be no known or apparent cause for its development.

Symptoms

There are a number of quite distinctive symptoms for carpal tunnel syndrome and these include -

  • Numbness, tingling akin to pins and needles, or pain – particularly on the side of the hand which houses the thumb, it is this classic symptom which often occurs through the night.

  • A feeling similar to a mild electric shock – particularly in the thumb and adjacent fingers

  • Pain radiating to the shoulder

  • Muscle atrophy around the base of the thumb

  • Wrist pain and grip weakness which may cause sufferers to drop things more often than usual!

Very rarely, carpal tunnel symptoms may appear in patients with pre-existing serious medical disorders such multiple sclerosis, sarcoidosis, leukemia, or multiple myeloma. Some patients with symptoms of carpal tunnel find that those symptoms disappear almost as spontaneously as they arrived, for others it may be necessary to have treatment, including surgery if the condition is severe.

Diagnosis

Initial diagnosis of carpal tunnel syndrome will be based on the patient’s own description of symptoms followed by a physical examination. The condition is then generally confirmed by nerved conduction testing.

Treatment

As with many conditions, the treatment of carpal tunnel syndrome is dependent on the severity of the condition and its underlying cause.

Initial treatment may mean abstaining from or modifying any repetitive activities which may be causing the symptoms. This may then be followed by a period of physical therapy and/or manipulation and the wearing of a wrist brace. Anti-inflammatory medication may be prescribed for any pain.

If the initial treatment fails to bring any improvement in the symptoms of carpal tunnel syndrome a cortisone injection into the carpal tunnel may be recommended.

Finally, if all other avenues of treatment have failed surgery is generally offered as the only remaining treatment option. Patients with advanced carpal tunnel require surgery in order to avoid permanent damage to nerves.

Surgery

Carpal tunnel decompression surgery is a simple surgical procedure which is carried out as an outpatient using a local anesthetic. The surgery involves an incision into the palm of the hand following which the surgeon will make a small incision into the carpal ligament thereby releasing the pressure causing symptoms. Recovery from the procedure takes around six weeks, during which time the patient will be unable to drive and will be instructed to do regular exercises with the affected hand. Some patients experience carpal tunnel symptoms in both hands and may require a further surgical procedure when they are fully recovered from the first one.

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