The carpal tunnel is about an inch-wide passageway in the wrist. While the floor and sides of the tunnel are formed by small wrist bones known as carpal bones. The roof of the tunnel is a strong band of connective tissue known as the transverse carpal ligament. Due to these very rigid boundaries, the carpal tunnel has little capacity to “stretch” or grow in size.
One of the main nerves in the hand is called the median nerve, which originates as a group of nerve roots in the neck. These roots come together to join a single nerve in the arm. The median nerve travels down the arm and forearm, passes through the carpal tunnel at the wrist, and goes into the hand. The nerve responsible for feeling in the thumb and index, middle, and ring fingers. The nerve also controls the muscles around the base of the thumb finger.The 9 tendons that bend the fingers and thumb also goes through the carpal tunnel. These tendons are called flexor tendons.
Carpal tunnel syndrome (CTS) is a medical disorder due to density of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are ache, numbness, and tingling, in the thumb, index finger, middle finger, and the thumb side of the ring fingers. Symptoms usually begin gradually and at night. Discomfort may extend up the arm. Weak strength of grip may experience and after a long time the muscles at the base of the thumb may waste away.
In most patients, carpal tunnel syndrome worsen over time, so early detection and treatment are important. There are several risk factors like obesity, repetitive wrist work, pregnancy, and rheumatoid arthritis. There is uncertain proof that hypothyroidism increases the risk. Another factor is the types of occupation which include computer work, work with vibrating tools, and work that requires a strong grip. Diagnosis is based on signs, symptoms, and specific physical tests and may be confirmed with electrodiagnostic tests.
You can decrease the risk of developing CTS by being physically active. Symptoms can be treated by wearing a wrist splint or with corticosteroid injections. Compared to non-surgical options, surgery to cut the transverse carpal ligament is more effective.
Recommended healthy habits such as avoiding repetitive stress, work modification through use of ergonomic equipment like mouse pad, taking proper breaks, using keyboard alternatives (digital pen, voice recognition, and dictation), have been suggested as methods to help prevent carpal tunnel syndrome.
Stretching and isometric exercises will help in prevention for individuals at risk. Stretching before the activity and during breaks will help in relieving tension at the wrist. Rest the hand firmly on a flat surface and gently press for a few seconds to stretch the wrist and fingers. You can try an example of an isometric exercise of the wrist which is done by clenching the fist firmly, releasing and fanning out fingers.
Biological factors like genetic predisposition and anthropometric features had significantly stronger causal link with carpal tunnel syndrome than occupational/environmental factors such as repetitive hand use and stressful manual work.
Generally recognized cures include: physiotherapy, steroids either orally or injected locally, splinting, and surgical release of the transverse carpal ligament.