Carpel Tunnel syndrome is a common condition that causes pain, numbness, tingling, and weakness in the hand and wrist. It takes place when there is increased pressure within the wrist on a nerve called the median nerve. This nerve provides sensation to the thumb, index, and middle fingers, and to half of the ring finger.
The carpal tunnel is a narrow canal or tube in the wrist. Similarly to a tunnel you could travel through by car, this part of the wrist allows the median nerve and tendons to connect the hand and forearm. The parts of this tunnel include:
Inside the tunnel are the median nerve and tendons.
The tendons of the hands are wrapped with a lining that produces a synovial fluid which lubricates the tendon. With repetative movemnets of the hands the lubrication system might malfunction. This reduction in the fluid results in inflammation and swelling of the tendon area. Abnormally high pressure area is created with the carpel tunnel syndrome patients. This pressure causes obstruction to venous outflow, back pressure, edema formation and ultimately ischemia to the nerve.
Pain
Paraesthesia
Numbness
Tingling
Patient often awake to shake their hand to provide the relief to the symptoms and this is known as flick sign
Inability to move the wrist and hands
Weakness and clumsiness in the hand—this may make it difficult to perform fine movements such as buttoning your clothes
Dropping things—due to weakness, numbness, or a loss of proprioception
The doctor might do physical evaluation and find out the diagnosis.
The physician might carefully examine your hand and wrist and perform a number of physical test:
Electrophysiological tests:
The doctor might check for the median nerve damage and examine the thumb finger.
Have another nerve condition, such as neuropathy, or other sites of nerve compression that might be contributing to your symptoms.
Electrophysiological tests may include:
Ultrasound:
An ultrasound uses high-frequency sound waves to help create pictures of bone and tissue. Your doctor may recommend an ultrasound of your wrist to evaluate the median nerve for signs of compression.
X-rays:
X-rays provide images of dense structures, such as bone. If you have limited wrist motion or wrist pain, your doctor may order x-rays to exclude other causes for your symptoms, such as arthritis, ligament injury, or a fracture.
Magnetic resonance imaging (MRI) scans:
These studies provide better images of the body's soft tissues. Your doctor may order an MRI to help determine other causes for your symptoms or to look for abnormal tissues that could be impacting the median nerve. An MRI can also help your doctor determine if there are problems with the nerve itself—such as scarring from an injury or tumor.
The pain might get subside within two to three months. But the complete recovery might take 1 year.
