Carpal Tunnel Syndrome: The Tingling Truth

So one late evening, I went to Emma’s house.

Emma is a dear friend, and for the past few months she’d been experiencing numbness in her hands. “Priya, the strangest thing happened,” she continued, rubbing her wrist. “I wake up at night feeling this zinging sensation go through my hand. Sometimes it sprays up into my arm. It’s driving me crazy.”

As a physician, I suspected with high likelihood that Emma had carpal tunnel syndrome, one of the most prevalent conditions identified, among other injuries, with compression of the median nerve as it travels through the wrist. I had tea with her to explain what was happening and how we could help her.

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) is a painful hand and wrist condition that occurs when the median nerve at the wrist becomes compressed. This nerve runs through the carpal tunnel, a narrow passageway in the wrist created by bones and ligaments. When those tissues surrounding the tunnel become swollen, they compress the median nerve, leading to the familiar sensations of tingling, numbness and pain.

With Emma, the pain had developed gradually, with bouts of tingling in between, getting worse over time, especially at night.

In what way is Carpal Tunnel Syndrom Diagnosed?

Carpal tunnel syndrome is quite common, particularly in middle-aged women and during pregnancy. During pregnancy, hormones begin coursing through the body, causing the tissues to become puffy, restrict blood flow and build pressure on the median nerve. People who do manual labor that requires repeated hand movements — computer use, carpentry or farming, for example — are also more likely to develop the condition.

Emma is a graphic designer who spends long hours working away on her PC and it made sense for her symptoms.

What Are Carpal Tunnel Syndrome Symptoms?

Complaints often related to CTS are:

• Numbness or tingling in the hands and fingers, most notably in the thumb, index and middle fingers
• Pain that can radiate into the arm
• Loses hold making it hard to interact with items
• Symptoms often begin in the night and wake patients from sleep
• More sensitivity when bending the wrist, as when using a phone or steering a car

The tingling sometimes woke Emma at night, she said, and she had to shake her hand to relieve the sensation.

What Is It: Carpal Tunnel Syndrome?

Carpal tunnel syndrome signifies median nerve compression in the carpal tunnel. This can be caused by:

• Repetitive uses of the Hands (i.e. typing, using tools)
• Fluid Retention (e.g., Pregnancy)
• Hormonal changes in women
• Chronic Inflammatory diseases like Rheumatoid arthritis
• Wrist injuries or impact

What Are the Carpal Tunnel Syndrome Risk Factors?

CTS is not life-threatening, but untreated, it can have a significant negative impact on quality of life. The main risks include:

• Hand weakness not resolving
• Numbness in the thumb, index, and middle fingers
• Loss of hand function that makes it hard to do simple daily tasks like writing, cooking or typing

Emma was particularly afraid of losing her ability to work, which required significant use of her hands. I promised her that with treatment, we’d be able to control her symptoms nicely.

How Is Carpal Tunnel Syndrome Treated?

CTS is a clinical diagnosis, although nerve conduction studies may be considered in select cases. These tests show how well electrical impulses move through the median nerve and can help confirm diagnosis.

I explained to Emma that if her symptoms persisted, we could refer her for a nerve conduction study to determine the extent of the problem.

What Are the Treatments for Carpal Tunnel Syndrome?

The good news is that carpal tunnel syndrome is usually treatable without surgery, especially if diagnosed early. Here’s what I told Emma to try:

Self-Care Measures:

• Rest: Activity should be limited if it worsens symptoms.
• Wrist Splint: A splint worn at night promotes a neutral position and ease on the median nerve.
• Pain Relief: Control pain and inflammation with over-the-counter pain medicine (ex: ibuprofen)

Medical Treatments:

• Fluid pills: In pregnant women fluid pills can be useful for the elimination of the swelling.
• Cortisone Injection: If you have more serious issues, sometimes a cortisone injection into the carpal tunnel itself can give truly amazing relief for months at a time.
• Surgery: If conservative treatment is unsuccessful, a minor surgical procedure can relieve pressure on the median nerve by cutting the ligament that forms the roof of the carpal tunnel.

Emma was so relieved to hear that the first treatment of choice was not surgery and that we could begin with some small treatments like wearing a wrist splint and taking parts of the repetitive motion out.

Different Strategies for Avoiding Carpal Tunnel Syndrome

All right, remember that old saying: Prevention is better than cure. I sent Emma a few tips I had gleaned to curb exacerbating her symptoms:

• Getting up, walking away from habitual tasks
• Avoid typing or using implement with your wrist
• Do stretchless for your hands and wristslets regularly to boost the blood flow
• Ergonomic devices are recommended to avoid loading of the wrists

Carpal Tunnel Syndrome — FAQs