Carpal Tunnel Syndrome
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Carpal Tunnel Syndrome is the name given to the malady that involves nerve entrapment at the inside of the wrist. The nerve that is entrapped is known as the median nerve as it is the central nerve of the wrist and hand. This nerve traverses through a small tunnel in the wrist known as the carpal tunnel which normally is wide enough to allow for free passage of the nerve without irritation or impingement. In carpal tunnel syndrome, however, the tunnel is narrowed due to a dislocation or fracture of one of the bones in the wrist or due to tendon inflammation or the inflammation of rheumatoid arthritis.
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| The condition is aggravated when the wrist is sharply flexed or overstressed and is typically found in those persons who use repetitious or excessive wrist motions i.e. bowlers, assembly-line workers, waiters, hairdresser, etc. Symptoms normally experienced include tingling in the fingers (often at night), clumsiness while gripping objects, numbness and pain in the wrist and fingers and, in more severe cases, atrophy (withering) of the thenar muscles (those surrounding the thumb). |
Although repetitious use of the wrist may precipitate carpal tunnel, the malady is also found in conjunction with advanced pregnancy probably due to generalized tissue swelling and with certain systemic diseases. In addition to rheumatoid disease, such diseases as thyroid dysfunction, leukemia, pulmonary disorders and diabetes have been associated with Carpal Tunnel Syndrome.
Occasionally, instead of radiating into the wrist and fingers, the pain and numbness of carpal tunnel syndrome may radiate upwards into the arm, shoulder, neck and even the chest. If the left wrist is involved, sometimes the chest pain in carpal tunnel is confused with angina pectoris.
Phalen's sign is the test most used to detect carpal tunnel syndrome. This is a neurological test that involves having the patient press the backs of the hands together with both wrists in full flexion (bent inwards) for 30-60 seconds. The sign is positive if the patient begins to experience the sensation of numbness and tingling in the hands.
Those who have suffered with carpal tunnel syndrome of long duration will often complain of inadvertently dropping things or inability to hold a pen or pencil. These same persons will also usually notice a general weakness in their hand muscles along with a swollen area around their wrist.
