Carpal tunnel syndrome
Source: http://umm.edu/health/medical/reports/articles/carpal-tunnel-syndrome
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of carpal tunnel syndrome.
Alternative Names
Repetitive stress injuries
Overview:
Carpal tunnel syndrome (CTS) develops from problems in a nerve in the wrist — not the muscles, as some people believe.
Symptoms of carpal tunnel syndrome usually progress gradually over weeks and months, or sometimes years.
Anyone with recurrent or persistent pain, numbness and tingling, or weakness of the hand should consult a doctor for an evaluation.
It is not completely known how the process leading to carpal tunnel syndrome actually evolves, and how nerve conduction (the transmission of the nerve signal) through the wrist changes.
In general, carpal tunnel syndrome develops when the tissues around the median nerve of the hand swell and press on the nerve.
Early in the disorder, the process is reversible. Over time, however, the insulation on the nerves may wear away, and permanent nerve damage may develop.
It is often very difficult to determine the precise cause of carpal tunnel syndrome
Risk Factors:
CTS is associated with a family history of the disorder.
Many studies indicate that women have a significantly higher risk for carpal tunnel syndrome than men do.
Older people are at higher risk than younger adults.
Treatment:
It is critical to begin treating early phases of carpal tunnel syndrome before the damage progresses.
A conservative approach to CTS, which may include corticosteroid injections and splinting, is the first step in treating this disorder.
Surgery is usually an effective treatment choicefor people with the more classic signs and symptoms of carpal tunnel syndromewho fail conservative treatment.
Introduction
Carpal tunnel syndrome (CTS) is a disorder that causes pain and weakness in the hand and wrist. CTS develops from problems in a nerve in the wrist — not the muscles, as some people believe. The symptoms of CTS can range from mild to incapacitating.
The Carpal Tunnel and Median Nerve
To understand how carpal tunnel syndrome arises, it is important to know the parts of the hand and wrist that are involved.
The Carpal Tunnel. The carpal tunnel is a passageway that forms beneath the strong, broad transverse ligament. This ligament is a bridge that extends across the lower palm and connects the bones of the wrist (carpals) that form an arch below the tunnel.
The Median Nerve and Flexor Tendons. The median nerve and nine flexor tendons pass under the ligament bridge and through the carpal tunnel (similar to a river). They extend from the forearm up into the hand:
The flexor tendons are fibrous cords that connect the muscles in the forearm to the fingers (two to each finger and one to the thumb). They allow flexing of the fingers and clenching of the fist.
The median nerve plays two important roles. It supplies sensation to the palm side of the thumb, index, middle, and ring fingers, and to the flexor tendons. It provides function for the muscles at the base of the thumb (the thenar muscle).
The median nerve travels through a compartment in the wrist called the carpal tunnel. The ligaments that traverse the nerve are not very flexible. Any swelling within the wrist compartment can put excessive pressure on structures such as the blood vessels and the median nerve. Excessive pressure can constrict blood flow and cause nerve damage. The symptoms from the compression cause pain, loss of sensation, and decreased function in the hand.
