Carpal Tunnel Syndrome

May 25, 2021 daradia_new 0 Comments

Carpal tunnel syndrome (CTS)

Introduction:

Median nerve compression in which the median nerve is compressed and causes weakness, numbness, and tingling in the hands this is syndrome is known as carpal tunnel syndrome. The median nerve runs along the length of the arm and goes into the hand through the passage in the wrist called carpal tunnel this is compressed and causes this syndrome (Wheeler,2019).

What are the symptoms of CTS?

Symptoms of carpal tunnel syndrome are like that of nerve pain:

  • Tingling that arise at the wrist and move upwards toward the arm.
  • Weakness in the fingers and hands causes problems in holding objects.
  • Shock-like waves that move towards the fingers.
  • Numbness, itching, tingling, and burning in the index finger or sometimes in middle fingers, thumb, and palm (Wheeler,2019).

What are the causes of CTS?

Patients usually don’t know the exact cause of carpal tunnel syndrome. But the following reasons can cause this syndrome:

  • Conditions like diabetes, obesity, rheumatoid arthritis, spondyloarthritis, and hypothyroidism.
  • Repetitive motions are the most common ad major causes of carpal tunnel syndrome. These motions include typing on the computer, writing, and any other wrist movements that we do over and over.
  • Pregnancy is another cause of carpal tunnel syndrome (Wheeler,2019).

What are the home treatments to relieve carpal tunnel syndrome?

Carpal tunnel syndrome is a painful and uncomfortable condition, so it can be treated at home in some healthy ways. Dr. Seitz says, “Think about the activities that are the causes of pain and numbness in the wrist and try to reduce or stop them to relieve pain” (Clevelandclinic,2016).

Here are some ways that can help to reduce pain at home:

  • Immerse the hand and wrist in warm water with a temperature range between 90 to 98 degrees and move the hand or wrist slowly in warm water.
  • NSAIDs or nonsteroidal anti-inflammatory drugs like naproxen or ibuprofen are also used to relieve pain.
  • Keep the hand properly aligned with the help of a wrist splint. It is used at night to keep the wrist from overextending or flexing while sleeping.
  • Ice the wrist or soak your hand in an ice bath for 10 to 20 minutes twice an hour (Clevelandclinic,2016).

Exercises for carpal tunnel syndrome:

In the case of some mild symptoms of carpal tunnel syndrome, some simple exercises help to get rid of the pain. But perform these exercises after consulting with a doctor.

These exercises are described as follows.

  • Fist to fan:

Make a fist of hand.

Fan the fingers outwardly and then stretch fingers as far as possible.

Repeat it 4-5 times.

  • Fist to stop sign:

Make a fist of hand.

Move the fingers upward or towards the ceiling, just like telling someone to stop.

Repeat 4-5 times(Wheeler,2019).

  • Wrist Flex and Extend:

Hold the hand and straight, arm straight in front of the face and palm of the hand facing down.

Point the fingers towards the ground by bending the wrist down.

Use the other hand to expand the stretch, slowly pulling the fingers towards the body.

  • Nerve Gliding:

Bend the elbow and make a fist towards the face.

straight the fingers out, thumb tucked in, and wrist neutral.

Bend the wrist away from you, then move it back.

Repeat 5 times (Wheeler,2019).

  •  Tendon Gliding:

Bend elbow and straighten the wrist, move the fingers straight towards the ceiling and thumb relaxed.

Curl fingers inward and then straighten to make an L-shape with the hand.

Fold the fingers down so they touch the palm, then curl the fingers into a regular fist.

Repeat 5 times (Wheeler,2019).

Interventional Pain Management for Carpal Tunnel Syndrome:

In moderate to severe cases, interventional pain management plays an important role. Following interventional procedures are done under ultrasound guidance:

  1. Steroid injection around the median nerve. Earlier this was done blindly, nowadays it is better done under ultrasound guidance.
  2. Hydro-dissection of the median nerve under ultrasound guidance: This is an injection or intervention procedure.  The median nerve which is entrapped under the flexor retinaculum is dissected with injection.

Surgery:

Surgical dissection of retinaculum-

  • Earlier, the operation was the best solution for this problem in moderate to severe cases. But recent studies are showing better results with ultrasound-guided hydro-dissection compared to surgery.

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