Carpal Tunnel Syndrome and other nerve entrapments
What is Carpal Tunnel?
There is a tunnel in the wrist called the carpal (wrist) tunnel through which nine tendons and the median nerve pass through. When pressure builds up in the tunnel, the nerve gets squeezed and becomes unable to function properly, which may result in numbness, discomfort and pain in the fingers.
Causes of carpal tunnel syndrome include:
- Previous wrist fracture, which may cause narrowing of the carpal tunnel
- Diabetes mellitus and some rare hormonal conditions as a risk factor
- Family members with the condition as a risk factor
- Fluid retention, which can cause swelling of tissues in the carpal tunnel
- Inflammatory conditions such as rheumatoid arthritis, which cause the lining of the joints and tendons in the carpal tunnel to swell
- Older age, which can cause changes in the soft tissue or bony structures of the wrist
- Women are more likely to develop carpal tunnel syndrome than men.
Symptoms usually include pain, numbness or tingling in the hand, fingers and sometime the forearm, which can occur during simple tasks such as holding the telephone or reading newspaper. People with the condition may have a weak grip.
Treatments for the condition with mild symptoms may include:
- Medication such as vitamin B6 and non-steroidal anti-inflammatory drugs (NSAID)
- Minimising wrist movement
- Oral diuretics or steroid injections to reduce swelling of the tissues
- Wearing splints or braces to relieve the pain
Surgery to divide the fibers (transverse carpal ligament) that press down on the nerve may be helpful. The surgery is often performed under local anaesthesia. Keyhole or “minimally invasive surgery”, with its advantages of a small incision and faster recovery, may be offered.