Carpal Tunnel Syndrome
The carpal tunnel is a structure formed by eight carpal bones in the wrist .The median nerve and the flexing tendons pass through this confined space. The median nerve is an important nerve that carries sensory signals to the thumb, index and middle fingers. The compression of the median nerve leads to carpal tunnel syndrome. Swelling of the protective sheath around the tendons is also a causative factor for developing this painful condition. This compression and swelling are the result of excessive strain on the wrist. Activities that involve forceful and repeated use of the wrist are potential risk factors for this disorder. Some such activities are sewing, cutting, golfing, canoeing, playing the violin and prolonged use of the computer keyboard.
The initial warning signs appear during the night. It includes pain and numbness in the hands. Patients often complain of tingling sensations and strange feelings in the entire arm. They also experience difficulty in grasping and picking up things. The fingers feel swollen, even though there is no evident external swelling. The onset of these symptoms is often taken as the indication of carpal tunnel syndrome.
Observance of the above mentioned symptoms could lead a doctor to suspect carpal tunnel syndrome. This can be further established by various diagnostic tests. Correct diagnosis would require the patient’s detailed and accurate medical history.
Physical examination: These involve simple tests that differentiate between carpal tunnel syndrome and other similar ailments. In the Tinel’s Test, the physician taps over the median nerve to produce a tingling sensation. In Phalen’s Test, the patients are asked to rest their elbows on a table and let the wrists dangle down with fingers pointing down. Carpal tunnel syndrome is diagnosed, if the symptoms occur within a minute.
Electro-diagnostic Tests: These tests help confirm the diagnosis. Nerve conduction studies and electromyographies analyze the electric waveforms of nerves and muscles and detect median nerve compression. Magnetic Resonance Imaging (MRI) is an accurate test to determine the severity of the condition. Wrist X-rays are not useful diagnostic tests.
Correct and timely diagnosis of the carpal tunnel syndrome goes a long way in choosing the line of treatment. With proper treatment, the carpal tunnel syndrome can be cured.