What is carpal tunnel caused by

Carpal tunnel syndrome is a painful, progressive condition that occurs when the median nerve in the wrist is compressed.

Also known as median nerve entrapment or median nerve compression, it may happen when a nerve swells, the tendons become inflamed, or something causes swelling in the carpal tunnel.

Symptoms include tingling, burning, or itching and numbness in the palm of the hand and the fingers, especially the thumb and index finger. CTS affects between 3 percent and 6 percent of adults in the United States.

It normally develops between the ages of 45 and 64 years, and the prevalence increases with age. It can appear in one or both wrists. It is more common in women than in men. Eventually, the median nerve can become severely damaged, and there may be permanent numbness in the fingers and permanent weakness in the muscles that are innervated by the median nerve.

It is often linked to computer use, but reports date back to the s. It was familiar to orthopedic surgeons since before the widespread use of computers.

The first symptoms often appear during the night, or on waking up in the morning. The discomfort may wake them repeatedly during the night. These symptoms occur in the thumb and the two fingers next to it, as well as half of the ring finger. They may extend to the rest of the hand and into the forearm.

As the condition progresses, symptoms may persist during the day. The person may lose grip strength and find it harder to form a fist or grasp small objects. Opening a bottle of soda, doing up buttons, or typing on a keyboard can become a challenge. If left untreated, the muscles at the base of the thumb may wither away, and the person may no longer be able to tell hot from cold with the thumb and finger.

Symptoms tend to emerge or get worse after using the affected hand. The sensation of tingling, burning, and pain may worsen if the arm or hand has been in the same position for a long time. Treatment aims to relieve symptoms and slow the progression of CTS by reducing pressure on the median nerve. People with mild symptoms may find their condition improves without treatment within a few months, especially if they are aged 30 years or under or if CTS occurs during pregnancy.

Most patients with mild symptoms who follow these strategies will notice an improvement within 4 weeks. The doctor may recommend corticosteroid injections to reduce inflammation. These are normally applied by injection, directly into the carpal tunnel. Tablets are available, but they are usually less effective. At first, the pain may increase, but it should start to reduce after 2 days. If the response is good, but symptoms return after a few months, another dose may be recommended.

However, continued use of corticosteroids is not advisable, as there can be long-term adverse effects. Non-steroidal anti-inflammatory drugs NSAIDs , such as aspirin or ibuprofen, may help relieve short-term pain. Contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture; an overactive pituitary gland; an underactive thyroid gland; and rheumatoid arthritis. Other factors that may contribute to the compression include mechanical problems in the wrist joint, repeated use of vibrating hand tools, fluid retention during pregnancy or menopause, or the development of a cyst or tumor in the canal.

Often, no single cause can be identified. Women are three times more likely than men to develop carpal tunnel syndrome.

CTS usually occurs only in adults. Workplace factors may contribute to existing pressure on or damage to the median nerve. The risk of developing CTS is not confined to people in a single industry or job, but may be more reported in those performing assembly line work—such as manufacturing, sewing, finishing, cleaning, and meatpacking—than it is among data-entry personnel.

Treatments for carpal tunnel syndrome should begin as early as possible, under a doctor's direction. Underlying causes such as diabetes or arthritis should be treated first. Carpal tunnel release is one of the most common surgical procedures in the United States. Generally, surgery involves severing a ligament around the wrist to reduce pressure on the median nerve.

Surgery is usually done under local or regional anesthesia involving some sedation and does not require an overnight hospital stay. Many people require surgery on both hands. While all carpal tunnel surgery involves cutting the ligament to relieve the pressure on the nerve, there are two different methods used by surgeons to accomplish this.

Recurrence of carpal tunnel syndrome following treatment is rare. Less than half of individuals report their hand s feeling completely normal following surgery.

Some residual numbness or weakness is common.. At the workplace, workers can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, and use correct posture and wrist position. Wearing fingerless gloves can help keep hands warm and flexible. On this page. The carpal tunnel Symptoms of carpal tunnel syndrome Causes of carpal tunnel syndrome Risk factors of carpal tunnel syndrome Non-surgical treatment for carpal tunnel syndrome Surgery for carpal tunnel syndrome Long-term outlook after surgery for carpal tunnel syndrome Where to get help Things to remember.

Carpal tunnel syndrome is a painful disorder of the hand caused by pressure on nerves that run through the wrist. Symptoms include numbness, pins and needles, and pain particularly at night. Anything that causes swelling inside the wrist can cause carpal tunnel syndrome, including repetitive hand movements, pregnancy and arthritis.

Possible treatments include rest, splinting, cortisone injections and surgery. The carpal tunnel The carpal tunnel is a narrow passageway in the wrist, which opens into the hand. It is surrounded by the bones of the wrist underneath and the transverse carpal ligament across the top. The median nerve runs through the carpal tunnel and gives feeling to the thumb, forefinger, middle finger and half of the ring finger.

Many tendons also pass through this carpal tunnel and if any swelling occurs, the large median nerve can easily be compressed, causing carpal tunnel syndrome. Flexor tendons run through the carpal tunnel into the hand. These tendons are covered by a smooth membrane called the tenosynovium and allow hand movement.

Any thickening from inflamed tendons or other causes of swelling can reduce the amount of space inside the carpal tunnel. If left unchecked, the median nerve is squashed against the transverse carpal ligament until the nerve cannot function properly. Numbness and pain are the result. It can affect one or both hands. The muscles of the thumb are also serviced by the median nerve. A person with advanced carpal tunnel syndrome may find they cannot properly use or move their thumb any more, and may find it difficult to grasp objects.

Symptoms of carpal tunnel syndrome The symptoms of carpal tunnel syndrome include: Numbness Pins and needles Pain, particularly at night Darting pains from the wrist Radiated or referred pain into the arm and shoulder Weakness of the hand The little finger and half of the ring finger are unaffected.

Causes of carpal tunnel syndrome In some cases the cause cannot be found. Sometimes there is a combination of factors such as: Arthritis — various types of arthritis, especially rheumatoid arthritis, can cause inflammation and swelling Pregnancy — the hormones associated with pregnancy cause general fluid retention, which can compress the nerve.

Carpal tunnel syndrome triggered by pregnancy usually goes away soon after birth Wrist fractures — bone fragments can irritate the tenosynovium or reduce the amount of space in the carpal tunnel Congenital factors — some people have a smaller carpal tunnel than others Overuse injury — the tendons in the carpal tunnel can become irritated and inflamed by awkward postures or repetitive hand movements. Risk factors of carpal tunnel syndrome Some people are at higher risk of developing carpal tunnel syndrome, including: Women between the ages of 40 and 60 years Pregnant women People with certain types of arthritis Anyone who experiences a period of rapid weight gain People who use their hands repetitively in their day-to-day activities, such as typists or assembly line workers.

At first, the pain and stiffness may be slight. But they may increase until your hand hurts all the time. You can suffer permanent damage if the cause is not addressed.