Carpal Tunnel: A real pain in the wrist

Carpal tunnel syndrome is a condition prevalent in those who spend a lot of time in front of the computer typing.  Seeing that this is a sports medicine blog however, this condition is seen in a wide range of populations with different underlying causes.  But before we get to that lets take a few steps back and define carpal tunnel syndrome.

The carpal tunnel is located on the anterior (palmar aspect of the wrist).  The floor of the structure is made up of your carpal bones and the roof by the transverse carpal ligament.  Within this space, about the circumference of your thumb, a number of structures run through it including the eight longer finger flexor tendons, their respected synovial sheaths, and the median nerve (Carpal Tunnel Image).  Carpal tunnel syndrome is a result of inflammation of the flexor tendons and their sheaths which leads to compression of the median nerve.  If you can imagine, an area about the circumference of your thumb could easily become crowded.  This condition is prevalent in those who repetitively perform actions that involve wrist flexion (i.e. typing), although it can also result from a direct trauma to the anterior portion of the wrist.

The main symptoms of carpal tunnel syndrome are numbness and tingling in your fingers and hand, specifically all fingers except for your pinky and also the lateral (outside) portion of the hand.  Holding a steering wheel, phone, or newspaper most often causes symptoms.  As the condition worsens motor skills of the hand may also begin to decrease.

A quick and easy way to test yourself for carpal tunnel syndrome is to perform the Phalen Test.  In order to carry out this test place the dorsal (backside) aspect of your hands together so that your wrists are fully flexed.  Hold this position for one minute.  If numbness and tingling are present this is indicative of carpal tunnel syndrome.

Initially conservative treatment is R.I.C.E. (Rest, Ice, Compression, and Elevation), immobilization, and NSAIDS.  For the individual who is susceptible to or is experiencing pain due to carpal tunnel syndrome, some home exercises may help alleviate the pain.  Exercises that include stretching and strengthening both the flexor and extensor tendons of the wrist in junction with R.I.C.E. with help reduce swelling in the carpal tunnel, the underlying cause of the condition. For pictures and descriptions of some exercises visit CT Exercises .

In most cases people tend to flex their wrist while they sleep, so a night splint (Image) which holds the wrist in a neutral position can be very beneficial to one with carpal tunnel syndrome.  On top of wearing the brace at night, a more functional one (Image) should also be worn throughout the day because the neutral positioning of the wrist places the carpal tunnel in its most widened state which decompresses the nerve.  In more severe cases a physician may turn to corticosteroid injections into the carpal tunnel to decrease swelling and inflammation; however more conservative treatments should always be attempted prior to this step.  And finally in the most severe of circumstances surgery may be offered.  When surgery is performed the transverse carpal ligament is cut to decrease compression of the median nerve.

Hopefully this blog finds those in need who are suffering from this common condition and sheds some light on what they are experiencing.  Good luck to those of you who relate to this article and we hope this blog helps you on your road to recovery.

References and Resources

http://www.eatonhand.com/hw/ctexercise.htm

http://orthopedics.about.com/cs/carpaltunnel/a/carpaltunnel_3.htm

http://www.mayoclinic.com/health/carpal-tunnel-syndrome/DS00326

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4 thoughts on “Carpal Tunnel: A real pain in the wrist

    1. Dr. Sabb,
      Thank you for the additional insight! You are right when you share some of the many sports where athletes are predisposed to to injuries to the Carpal Tunnel. Please keep checking back in and feel free to comment whenever you see fit.

  1. Thanks for the article! There is also new do-it-yourself video geared for mild to moderate carpal tunnel syndrome. Developed by hand therapists with over 40 years of clinical experience, it provides education, gentle exercises, and tips on activity modifications. It’s a great resource to manage the condition as early as possible. Readers can visit http://www.TreatYourselfTherapy.com for more information.

  2. Some test can help you to determine if you have the signs of CTS. This maneuver can help you:
    You rest your elbows on a flat surface such as a desk, with your elbows bent and your forearms up. You then flex your wrists, letting your hands hang down for about 60 seconds. If you feel tingling, numbness, or pain in the fingers within 60 seconds, you may have carpal tunnel syndrome.
    Please visit on this site for further information.http://carpaltunnelhq.com/carpal-tunnel-symptoms/

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