What is the Carpal Tunnel?
The first thing to know about Carpal Tunnel Syndrome is to understand what the Carpal Tunnel is in the first place.
The Carpal Tunnel refers to an inch-wide passageway inside the wrist, the floor and sides of which are created by the surrounding carpal bones. An important thing to note about the carpal tunnel is that it is neither flexible nor expandable, due to it being limited by the strong transverse carpal ligament above it.
Within the carpal tunnel itself lies the Median nerve. It is one of the main nerves in the hand that extends through the arm and forearm into the hand, and provides sensation to the fingers except the little finger. It also controls the cluster of muscles below the thumb.
So what is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome then refers to an increased pressure being put on the Median nerve. This can happen because of the tunnel becoming more narrow, or when tissues around the flexor tendons (tendons that control finger movement) swelling up.
Less space in the tunnel means more crowding by the tissues, and this can lead to them pressing on the Median nerve, causing Carpal Tunnel Syndrome.
What are some causes of Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome has a variety of factors that can contribute to it happening, some of them being:
● Heredity: Anatomical differences from family traits can result in direct changes in the spacing of individual peoples’ carpal tunnels.
● Repetitive Hand Use: Moving the hand and wrist in the same pattern of movements over and over, extended throughout a long period of time can stress the tendons in the wrist.
● Positioning: Unnatural, extreme or sudden, extensive movement/flexion of the wrist can cause nerve pressure
● Health Conditions: Some pre-existing health conditions such as diabetes or rheumatoid arthritis are usually also related to Carpal Tunnel Syndrome.
Symptoms of Carpal Tunnel Syndrome:
Some of the common symptoms of Carpal Tunnel Syndrome include pain in the 4 fingers besides the little finger, which are the digits directly under the control of the median nerve. This pain can be accompanied by tingling or numbing sensations.
Occasionally, you might even experience a shocking feeling, as if you were touched by a bit of electricity, radiating toward the same 4 fingers.
Some of the tingling and pain feelings can also begin to move upward at the shoulder area.
Sometimes, you might also experience weakness or an inability to conduct finer movements in the hand. Small tasks such as buttoning clothes might become exceedingly difficult to do.
Loss of control resulting in dropping items is another symptom you might experience with Carpal Tunnel Syndrome, or even a loss of perception of where your hand is.
At the beginning, Carpal Tunnel Syndrome symptoms can appear to be fleeting and gradual. Most people will only feel them in bursts before they go. When it becomes more serious over a period of time, the symptoms may persist longer too.
Treatment and Prevention
More often than not, Carpal Tunnel Syndrome can be treated without any need for surgery or advanced medical procedures, provided diagnosis has been attained within a relatively early time.
Some non-surgical treatments include bracing or splinting the wrist. This means wearing a brace or a splint around the wrist to keep it from bending, usually at night. Doing this reduces pressure on the Median nerve. This can also be done in the day during activities that usually aggravate the symptoms.
Painkillers like nonsteroidal anti-inflammatory drugs (NSAIDS) can help to relieve some of the pain and bring down the inflammation levels in the wrist, taking pressure off the nerve.
Physiotherapy administered by a doctor or physical therapist can help make the Median nerve more flexible within the carpal tunnel itself. You will need a professional consultation for this.
Steroid Injections are another option that can be pursued. Corticosteroid is an anti-inflammatory agent that can be injected directly into the carpal tunnel. It would be good to note, however, that although pain symptoms can be relieved the effects are usually temporary.
For a more long term solution, activity changes can ensure a more consistent improvement in symptoms. Should your profession or any recreational activity you engage in requires prolonged wrist extension or stress, it would be wise to change or modify the activities to alleviate the stress placed on the wrist.
When it comes to surgery for serious cases, there are 2 main ways to go about doing it, open or endoscopic, but their end products are essentially the same thing.
Surgery would focus on carpal tunnel release, which involves cutting the transverse carpal ligament, which is the roof of the carpal tunnel, and then allowing it to grow back together which provides more space in the carpal tunnel, hopefully taking pressure off the Median nerve.
Now, in order to prevent carpal tunnel from happening in the first place, rest and relaxation for the wrist during and after strenuous activities is necessary. It is also important to try not to put the wrist under too much pressure during the activity too. You could also try the following exercises to stretch and relax the wrist:
1. Wrist Extension/Flexion Stretch
Straighten the arm and bend the wrist backward so your fingers face either the ceiling or the floor, as per the images below. Use your opposite hand to pull the fingers of your stretching hand backward until you feel a stretch on the inside of the forearm. Hold this position for 15 seconds and then switch to the other arm Do this 5 times for each arm once an hour
2. The Shake
This exercise is very simple. Simply shake your hands as if you just washed them and are trying to get rid of excess water. Do this once every hour.
The 2 given exercises aim to stretch and relax the median nerve, to relieve the stress and tightness of it in an attempt to prevent pain and stiffness.
Times like now when Covid-19 is shifting plenty of work to the home, long hours in front of a computer are common, and that’s when many people might find carpal tunnel becoming more and more of an issue. Do ensure to take proper care and appropriate rest.