Carpal Tunnel Syndrome: Causes, Symptoms, Diagnosis & Treatment

Medically Reviewed By : Dr K. Hari Chandana

( Fellowship in Trauma, Fellowship in Pain Management )

Do You Feel Like Your Hand is Heavy and Numb?

Very few know the term carpal tunnel syndrome. Tunnel sounds like a familiar term; does it mean the same in the body?

Yes, there is a tunnel-like structure in the hand in which the nerve passes, known as the median nerve. If this nerve is compressed, it causes carpal tunnel syndrome. In the initial stages, the symptoms are not intense, but as time progresses, they worsen. So to know about its diagnosis, treatment becomes necessary on time.

carpal tunnel syndrome

What is carpal tunnel syndrome?

It’s a neurological problem, as the nerve is involved. The basic function of the nerve is to provide sensation and help in carrying out the movement of that part. 

Basically, in the hand area, there is a tunnel-like structure in which the median nerve passes along and supplies mainly the thumb, index finger, middle finger, and a part of the ring finger but not the little finger. So sensation and movement in this area are controlled by the median nerve.

When this median nerve is affected or compressed in the canal for any reason, it results in carpal tunnel syndrome.

What are the causes of carpal tunnel syndrome?

Any condition causing nerve damage, inflammatory arthritis, or the wrong wrist using positions, deformities, or dislocations can pose this problem, irrespective of sex or ethnicity. So the causes can vary.

What are the symptoms of carpal tunnel syndrome?

How to diagnose carpal tunnel syndrome:

Doctors generally prefer a physical examination first to confirm the diagnosis before conducting the tests

1. Physical examination:
2. Case-taking is done:

Along with the physical examination, history-taking is conducted to inquire about the history of a wrist injury, occupation, family history, diabetes, hypertension, or any inflammatory arthritis.

3. Nerve conduction studies:

It is carried out to see the extent to which the median nerve is affected. What are the causes of compression, whether the nerve supplying the hand area is giving proper sensation to that part or not?

4. Electromyogram:

It detects nerve damage. The nerve enters the muscle and supplies sensation and movement to the muscle through electrical stimulation. As the nerve is damaged, it lacks electric stimulation signals. 

5. USG

It detects the site of compression and its causes 

6. Magnetic resonance imaging

 it helps to detect the compression if it is due to a cyst, a tumor, or any abnormal tissues causing pressure on nerves. It also detects scar tissue if there is a history of any previous injury.

7. X-rays:

It can diagnose dislocations in the wrists or fractures causing compression of the nerves.

What is the treatment?

If carpal tunnel syndrome is diagnosed in the primary stage. Some precautionary measures are helpful to reduce the intensity of symptoms and the disease itself.

1. Primary measures to be taken:

So, the surgical procedure is aimed at making the passage wider so that the nerve does not compress. There is a ligament known as the transverse carpal ligament that is released in surgery so that the pressure on the nerve decreases and blood flow becomes normal to the nerve. This procedure is done in the outpatient department. General or local anesthesia is given.

2. Open ligament surgery:

In this surgical procedure, general anesthesia is given

The cut or incision is given on the palmar surface of the hand, and the transverse carpal ligament is half cut and divided towards the roof so that it creates more space in the tunnel and pressure is released.

3 .Endoscopic ligament surgery:

This surgery is just like open ligament surgery.

In this procedure, a small cut is made on the palm like a whole so that an endoscope can be inserted through it and the wrist can be visualized. The rest procedure is similar to open ligament surgery.

After surgery, the patient is told to move the hand to reduce swelling and pain. It takes a few days to heal the incision and almost 1-2 months to relieve the symptoms. 

If carpal tunnel syndrome is associated with other morbid conditions like diabetes, inflammatory arthritis, or thyroid disorders. The main root-cause treatment is essential. Treating diabetes or arthritis becomes the first line of treatment.