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Carpal Tunnel Syndrome

 
  Source: Article first appeared on SingHealth Calendar  
     
 

With so much work involving your hands, it’s no wonder they are put under pressure. To 'rest and relax' is your first line of defence when it comes to your hands.

All in your hands

The carpal tunnel is that part of the wrist which the median nerve as well as the muscle tendons run through. The median nerve controls some of the thumb and finger movements. Carpal Tunnel Syndrome, or CTS, occurs when this median nerve is compressed by the wrist ligament, leading to pain, numbness and weakness of the fingers and thumb. Untreated, these symptoms can get worse and result in permanent neurological deficits such as weakness or loss of sensation.

CTS occurs in:

  • People who are born with narrower carpal tunnels
    • This condition is three times more common in women
  • People whose work involves repetitive wrist movements
    • Eg. flexing the wrist when using the mouse
  • Those who have diabetes, obesity, hypothyroidism and rheumatoid arthritis
  • Those who have suffered injury to the wrist
  • Pregnant women

Nerve Conduction Study (NCS) and Electromyogram (EMG) are tests that can confirm CTS. The NCS involves giving tiny electric shocks to the median nerve and recording its electrical signals across the wrist. It usually takes about half an hour. It is a safe procedure and does not require any sedation or anaesthesia.

Treatment for Carpal Tunnel Syndrome

  • Wear a splint to keep the wrist in a neutral position during sleep.
  • Avoid repetitive movements eg prolonged typing.
  • A course of anti-inflammatory medication, such as NSAIDS, may provide some symptomatic relief.
  • In selected cases, a steroid injection into the carpal tunnel provides quick (but temporary) relief.
  • If the symptoms are severe or if there is significant nerve damage, surgery to release the compressed nerve should be considered. This is a simple, effective, outpatient procedure performed under local anaesthesia.

Special thanks to the Department of Neurology, National Neuroscience Institute. National Neuroscience Institute is the leading regional specialist centre for cutting-edge treatment in the neurosciences, treating illnesses affecting the brain, spine, nerve and muscle. 

Ref: V10

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