Carpal tunnel syndrome (CTS)
This is a painful and progressive condition caused by compression of a key nerve in the wrist. It occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. Symptoms usually start gradually with pain, weakness or numbness in the wrist and hands radiating up the arm. As symptoms worsen tingling in the fingers (classically the thumb, index and middle fingers) may occur and decreased grip strength can make it difficult to form a fist, grasp small objects or perform other manual tasks. Symptoms can be particularly troublesome at night and are sometimes relieved by hanging the arm over the side of the bed. It can affect one or both hands.
Cause
In some cases no direct cause of Carpal tunnel syndrome can be identified but it tends to occur in young and middle aged women and is particularly common in pregnancy. It is thought that some people have a narrower carpal tunnel than others and it takes only a very small amount of swelling or retained fluid to put pressure on the nerve. The syndrome is common in those performing assembly line work or doing other repetitive tasks with the hands,
Treatment
Initial treatment usually involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms and immobilizing the wrist in a splint. Ice packs, steroids (taken by mouth) or local anaesthetic (injected directly into the wrist) can relieve swelling and pressure on the median nerve and provide immediate, temporary relief. Stretching and strengthening exercises can be helpful when symptoms have abated. If symptoms last for 6 months or more surgery may be recommended to sever the band of tissue around the wrist and reduce pressure on the medina nerve.
Prognosis
Recurrence of carpal tunnel syndrome following treatment is rare and the majority of patients recover completely. There has been some research into the possibility of using acupuncture to treat CTS.
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