Carpal Tunnel Syndrome

Carpal Tunnel Syndrome results from compression of the median nerve as it enters the hand within the carpal tunnel. Wrist bones provide three of the four sides of the carpal tunnel with the thickened and unyielding transverse carpal ligament or flexor retinaculum enclosing the canal.

Pressure on the nerve leads to numbness and tingling of the thumb, index, middle and outer half of the ring fingers. Symptoms typically begin during the nighttime and may interrupt sleep. Complaints linked to the carpal tunnel syndrome may become more intense over time with daytime manifestations often associated with activities involving repeated bending of the wrist. Pain may ultimately occur in the palm and forearm.

One in ten people will develop the carpal tunnel syndrome over a lifetime with a peak around age 50. Women appear more likely to experience symptoms than men especially after age 60. Risk factors remain the subject of debate.

Since most cases resolve within months initial treatment of the carpal tunnel syndrome should be conservative. Modification of activities, ice, heat, acetaminophen, a splint and stretching exercises appear helpful. For recalcitrant cases an injection of steroids mixed with a local anesthetic may provide temporary relief. Ultimately surgery may be necessary but carries some risks.

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