Carpal tunnel syndrome (CTS) is the condition that results from increased pressure on one of the nerves in the wrist and hand. In patients with carpal tunnel syndrome, this nerve is compressed as it passes through the wrist. Because of the compression, the nerve does not function properly.
Carpal tunnel syndrome is caused by pressure on the median nerve.
The median nerve runs from your forearm through a passageway in your wrist (carpal tunnel) to your hand. It provides sensation to the palm side of your thumb and fingers, except the little finger. It also provides nerve signals to move the muscles around the base of your thumb (motor function).
Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation resulting from rheumatoid arthritis.
There is no single cause in many cases. It may be that a combination of risk factors contributes to the development of the condition.
One can have a wide variety of carpal tunnel syndrome symptoms, but the condition typically causes numbness and tingling (paresthesias) in the hand, weakness in some of the muscles of the hand, and pain in the hand and wrist. Many of these symptoms become more pronounced at night, and patients with this condition often complain of inability to sleep.
Treat carpal tunnel syndrome as early as possible after symptoms start.
Take more frequent breaks to rest your hands. Avoiding activities that worsen symptoms and applying cold packs to reduce swelling also may help.
Other treatment options include wrist splinting, medications and surgery. Splinting and other conservative treatments are more likely to help if you’ve had only mild to moderate symptoms for less than 10 months.
Nonsurgical therapy
If the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome, including:
If carpal tunnel syndrome is caused by rheumatoid arthritis or another inflammatory arthritis, then treating the arthritis may reduce symptoms of carpal tunnel syndrome.
Surgery
Carpal tunnel release
Surgery may be appropriate if your symptoms are severe or don’t respond to other treatments.
The goal of carpal tunnel surgery is to relieve pressure by cutting the ligament pressing on the median nerve.
The surgery may be performed with two different techniques: