Carpal tunnel syndrome is a condition that affects the wrist, hand, and fingers. It can involve one hand or both hands. Carpel tunnel syndrome occurs most often in women between 40 and 60 years of age, but can occur in anyone. To understand carpal tunnel syndrome, it is necessary to understand some basic anatomy of the wrist and hand.
The bones in the wrist, called carpal bones, and the bones of forearm, called antebrachial bones, form a small arch similar to a horseshoe, but somewhat flatter. The closed part of the arch is on the back of the wrist. The open side of the arch faces the inside of the wrist. Ligaments, which are strong leather-like bands, attach to each side of the open "horseshoe" to create a small tunnel.
The median nerve is the main nerve that passes through this arch along with many of the tendons in the fingers. The median nerve provides sensation in the palm of the hand, mainly the thumb, index finger, and middle finger. This nerve also controls several muscles in the thumb and fingers. Carpal tunnel syndrome can occur when there is an injury or inflammation in the wrist area.
Overuse or repetitive injuries, such as extensive typing, can cause scar tissue to gradually build up in the carpal tunnel. This scar tissue can eventually create compression on the median nerve, which causes tingling or loss of feeling in the palm and fingers. It also can cause muscle weakness in the thumb and fingers.
If you treat carpal tunnel syndrome in its early stages with proper physical therapy procedures and modify the activities that are causing the problem, it might be possible to alleviate or reduce the symptoms and stop the progression of the syndrome. Your physician might prescribe anti-inflammatory drugs to help decrease inflammation. Early intervention usually includes specific hand and finger exercises to help relieve pressure on the median nerve. Ultrasound can be used to decrease inflammation. Modifying activity by creating rest periods, providing periodic alternate hand activities, adjusting computer workstation positions, and providing better wrist support or position also might help.
If early treatment does not resolve the problem, surgery might be required to remove the scar tissue, which usually eliminates the cause of the nerve compression. After surgery, physical therapy is usually prescribed to regain range of motion and strength in the wrist, hand, and fingers.
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