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Carpal Tunnel Syndrome

 
  Source: Article first appeared on SingHealth Calendar (2010)  
     
 

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

All in Your Hands

The carpal tunnel is that part of the wrist through 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 may get worse and result in permanent neurological deficits such as weakness or loss of sensation.

CTS Points the Finger at:

  • Those who are born with narrower carpal tunnels
    • This condition is three times more common in women
  • Repetitive wrist movements
    • Eg. flexing the wrist when using the mouse
  • People with 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. It involves giving tiny electric shocks to the median nerve and recording its electrical signals across the wrist. The test usually takes about half an hour. It is a safe procedure that does not require any sedation or anaesthesia.

HELP is at Hand

  • 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, 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. 

 
 

 

 
     
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