CARPAL TUNNEL SYNDROME (CTS)

What is Carpal Tunnel Syndrome (CTS)

Carpal tunnel syndrome is a painful, debilitating condition that can make it difficult to do ordinary daily tasks like gripping and can cause substantial night agony and discomfort. Pressure on the median nerve, which is located on the inside of the wrist, causes it to swell. It is common among pregnant and postpartum women, as well as individuals who work in physical labour, such as builders, and those who spend long hours at a computer with poor ergonomics and posture. It’s also linked to other medical issues including diabetes and thyroid issues like hypothyroidism.
Carpal tunnel syndrome treatment differs depending on the particular source of your problem. Physiotherapy, activity adjustment, and anti-inflammatories can help relieve your pain symptoms. A wrist splint can help reduce pressure on the nerve by maintaining your wrist in a neutral posture, especially during night. To alleviate your discomfort, we recommend wearing a wrist splint at night for at least four weeks. If your symptoms do not improve, an ultrasound-guided steroid injection to ease the pressure on the nerve is recommended. Before considering surgical intervention, we always propose a steroid injection because many procedures can be avoided.

What are the symptoms of Carpal Tunnel Syndrome?

Carpal tunnel syndrome causes the following symptoms:

  • Pain in your fingers and hands, especially in the pad of your thumb, index, and middle finger.
  • Weakness and a hard time gripping.
  • Pins and needles, as well as numbness in the hand, making you desire to shake it to relieve the sensations.

If this sounds like you, keep reading…

What disorders can be mistaken for Carpal Tunnel Syndrome?

If this does not sound like your pain, there are a number of other conditions that might cause it, including:

  • Wrist osteoarthritis, a type of osteoarthritis that affects the joints in the wrist.
  • Tenosynovitis of DeQuervain
  • Thumb osteoarthritis,  a type of osteoarthritis that affects the joints of the thumb.
  • Scapholunate ligament injury due to a rip in the triangular fibrocartilage complex (TFCC).

Carpal tunnel syndrome vs. wrist osteoarthritis (OA):

The primary difference is that carpal tunnel syndrome is a nerve compression that causes pins and needles and hand weakness, but osteoarthritis of the wrist affects the joint and does not cause similar nerve-related symptoms. Wrist Carpal tunnel syndrome is not linked with severe stiffness and edoema at the wrist joint, unlike osteoarthritis, which causes thickening and swelling of the wrist joint with pain and stiffness.

Anatomy

The carpal tunnel is a channel made up of tendons, ligaments, and bones that connects the wrist to the hand. The median nerve runs through the tunnel, providing feeling to the thumb, index, middle, and thumb side of the ring finger. Carpal tunnel syndrome (often referred to as CTS) is a prevalent ailment that affects up to 16% of the population in the United Kingdom. Carpal tunnel syndrome affects three times as many women as it does males. New mothers, manual labourers such as builders and bricklayers, and individuals who spend a lot of time at their desk are all susceptible to it.

Carpal tunnel syndrome is a disorder that affects the wrist and hand, causing discomfort, pins and needles, and numbness (reduced/altered sensation). These symptoms are typically felt in the pattern depicted in the diagram below. Symptoms are frequently worse at night, first thing in the morning, or after lengthy computer use.
Carpal tunnel syndrome can also cause hand and wrist weakness as well as a limited range of motion. Muscle wasting in the hand, particularly the ‘pad’ of the thumb, known as the thenar eminence, can occur in more severe or long-term/chronic cases.

How to diagnose Carpal Tunnel Syndrome?

A diagnosis and cause will be determined after a complete assessment and physical examination. One of our specialist clinicians, all of whom have extensive experience with this condition, will perform this procedure.

A diagnostic ultrasonography scan will also be performed to visualise the median nerve. The median nerve is swollen in carpal tunnel syndrome. On ultrasonography, the increase in nerve size can be seen clearly and easily compared to the other side to help confirm the diagnosis. When it comes to diagnosing carpal tunnel syndrome, ultrasound is just as reliable as nerve conduction testing. This will be completed within your scheduled appointment time, and there will be no additional charge.
Other illnesses that can resemble the symptoms of carpal tunnel syndrome must also be ruled out. Referral from the neck is one of the most common illnesses that mimics the symptoms. Compression of a nerve in the neck, such as from a disc condition, can produce discomfort, pins and needles, and numbness in the wrist and hand.

How do you treat Carpal Tunnel Syndrome?

An ultrasound-guided injection, personalised physiotherapy, and lifestyle adjustments may all be part of a specific treatment strategy. This will be determined by the severity of your ailment and previous treatments.
We’ll also take into account influencing factors like your posture and work environment.
We recommend getting a workstation assessment if your symptoms begin as a result of extended sitting at a desk.
Over-the-counter and prescription medications are two more non-surgical options.
A two-week trial of wrist splints may also be recommended (see image below). We recommend that patients simply wear the splint at night to see if their symptoms improve. The splint retains the nerve in a neutral posture, giving the carpal tunnel some breathing room. This may provide enough time for the nerve’s irritation to subside and symptoms to fade. Splints are available from most pharmacies.