Carpal Tunnel Syndrome
Courtesy:Mt. Elizabeth Hospital- Singapore
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is also known as a entrapment neuropathy disease in which one of the body’s nerves is pressed causing pain and other issues. In CTS, the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand. This houses the median nerve and the tendons that bend the fingers. The median nerve provides feeling to the palm side of the thumb and to the index, middle, and part of the ring fingers.
What are the symptoms of CTS?
When your hand or arm starts feeling a numbness, thumb weakness, dull aching or tingling sensation, due to the compression of the median nerve, it is the beginning of CTS. Initially it is more pronounced in the nights but later starts happening in the day time too. Since the grip strength gets reduced, you may not be able to grasp even small items,
What are the treatment methods for CTS?
As with any disease, starting treatment early can help a lot. The best treatment is taking rest, or repetitive hand and wrist movement. Some of the natural and medical (non-surgical methods) are described below:
Take more frequent breaks to rest your hands. Avoiding activities that worsen symptoms and applying cold packs to reduce swelling also may help.
A splint that holds your wrist (esp. for pregnant ladies) still while sleeping can help relieve nighttime symptoms of tingling and numbness.
using the largest joints possible when lifting, such as the shoulder, to avoid strain on the wrists, hands, and fingers
not holding objects in the same way for too long
avoiding power tools that vibrate, such as jackhammers and floor sanders
A few medicines are also prescribed for this condition
Nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin IB, others), may help relieve pain from carpal tunnel syndrome in the short term.
Corticosteroids. Your doctor may inject your carpal tunnel with a corticosteroid such as cortisone to relieve pain. Sometimes your doctor uses an ultrasound to guide these injections.
Corticosteroids decrease inflammation and swelling, which relieves pressure on the median nerve.
Surgery is usually a last stage measure and prescribed when all other methods fail.
Carpal tunnel surgery is done to relieve the pressure by cutting the ligament pressing on the median nerve.
The surgery may be performed with two different techniques:
Endoscopic surgery. Your surgeon uses a telescope-like device with a tiny camera attached to it (endoscope) to see inside your carpal tunnel. Your surgeon cuts the ligament through one or two small incisions in your hand or wrist.
Endoscopic surgery may result in less pain than does open surgery in the first few days or weeks after surgery.
Open surgery. Your surgeon makes an incision in the palm of your hand over the carpal tunnel and cuts through the ligament to free the nerve.
During the healing process after the surgery, the ligament tissues gradually grow back together while allowing more room for the nerve. This internal healing process typically takes several months, but the skin heals in a few weeks.
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