Understanding Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition that causes pain, numbness, and tingling in your hands and fingers. Carpal tunnel syndrome occurs when the median nerve is compressed and squeezed.The carpal tunnel is a narrow passage that contains the median nerve and tendons that bend the fingers. Sensations from the hand are transmitted to the brain via the median nerve, and the brain then transmits impulses to the muscles. Simply put, it helps communicate to the brain what the hand senses and causes the muscles of the hand to move.

If carpal tunnel syndrome is left untreated for an extended period, it can worsen and cause dysfunction of the hand, including loss of sensation in the fingers.

What are the symptoms of Carpal Tunnel Syndrome?

Symptoms of carpal tunnel syndrome include:

• Numbness or tingling in the fingers, particularly the thumb, index, middle and ring fingers
• Numbness or pain that worsens at night and wakes you up from sleep
• Shock-like sensations that radiate to the thumb, index, middle and ring fingers
• Weakness in the hands - difficulty in holding and gripping items

What are the risk factors for Carpal Tunnel Syndrome?

Carpal tunnel syndrome can occur at any time, regardless of age. There are a few risk factors that contribute to this. Among them are:

• Gender: Women are more likely to develop carpal tunnel syndrome than men.
• Genetics: The carpal tunnel can be naturally smaller among some people. Family history of carpal tunnel syndrome.
• Position of hand and wrist: Repetitive hand and wrist movements over an extended period could also cause pinching of the nerve.
• Health conditions: Such as diabetes, rheumatoid arthritis, and thyroid gland imbalance.
• Pregnancy: Swelling that results in pressure on the nerve due to hormonal changes during pregnancy.

How is Carpal Tunnel Syndrome diagnosed?

Diagnosis is made based on various investigations. Your doctor will first evaluate your medical history and symptoms before conducting a physical examination.

1. Electrophysiological tests: To evaluate if there is too much pressure on your median nerve.
   • Nerve conduction studies (NCS)
   • Electromyogram (EMG)
2. X-ray: Images of dense structures like bone are provided by X-rays.
3. Ultrasound: High-frequency sound waves are used in ultrasound to help create images of bone and tissue. An ultrasound of the wrist may be suggested to check for signs of median nerve compression.
4. Magnetic Resonance Imaging (MRI) scan: MRI scans provide detailed images of the soft tissue.

How is Carpal Tunnel Syndrome treated?

There are several surgical and non-surgical approaches to treat carpal tunnel syndrome.

Non-surgical treatments

1. Splinting: Wear a wrist splint at night to relieve pressure on the nerve by keeping hands in a neutral position.
2. Change in activity: Engaging in activities that require the flexing and extension of the hand and wrist for a prolonged time should be avoided or minimised.
3. Steroids: A powerful anti-inflammatory agent can be injected into the carpal tunnel. It can assist in calming a flare-up of symptoms or relieving painful symptoms.
4. Hand exercises: May be beneficial for some patients.

Surgical treatments

Your doctor may recommend surgery if your symptoms worsen or if other treatments have not improved your symptoms. Surgical treatments include:

1. Open carpal tunnel release: A small incision is made in the wrist and the transverse carpal ligament is cut to ease the pressure on the median nerve.
2. Endoscopic carpal tunnel release: During this minimally invasive carpal tunnel surgery, the surgeon makes a small incision in the wrist and inserts an endoscope (a camera attached to a narrow tube) to view the inside of your wrist. A special knife is then used to cut the transverse carpal ligament similar to the open carpal tunnel release.

In most instances, carpal tunnel surgery is performed as a day-care procedure, and you are not required to stay overnight at the hospital.

Carpal tunnel release is usually recommended if you have experienced symptoms such as pain, numbness, and tingling sensation on a moderate to severe degree that lasts six months or longer. The pain will usually be relieved immediately after the surgery, but the numbness and tingling sensation may take a longer duration to heal.

How to prevent Carpal Tunnel Syndrome?

There are no specific methods to prevent carpal tunnel syndrome. However, you can minimise the risk by practising the techniques below:

• Take frequent breaks. Occasionally, stretch and gently flex your wrists.
• Maintain good posture.
• Keep hands warm.
• Ensure the computer mouse does not strain your wrist.

Book an appointment at Pantai Hospitals

Early detection of carpal tunnel syndrome makes it easier to treat the condition with effective and appropriate treatment. A dedicated and expert team of Orthopaedic specialists at Pantai Hospital is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding carpal tunnel syndrome. We assure you the best possible care tailored to your specific needs.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.