Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies. It affects mainly middle-aged women. In the majority of patients, the exact cause and pathogenesis of CTS are unclear. It happens when the carpal tunnel inside your wrist swells and squeezes 1 of your nerves (median nerve).
This may causes
Pain radiating to the forearm, elbow or even the shoulder.
An ache or pain in your fingers, hand or arm.
Numbness on hand.
Tingling or pins and needles.
Clumsiness and weakness in the affected hand (weak thumb or difficulty gripping).
These symptoms often start slowly and come and go. They're usually worsening at night.
Carpal tunnel syndrome can occur due to many causes. Such as exertion strain, overuse, repeated or prolonged wrist extension. prolonged grasping of tools and unaccustomed manual work also causes this condition. It is also associated with burns, coagulopathy, local infection and injections.
You are in more risk to develop carpal tunnel syndrome if you are overweight or pregnant. pregnant women are commonly diagnosed with this condition during the third trimester of pregnancy and it is often bilateral The risk of CTS is high in occupations involving exposure to high pressure, high force, repetitive work, and vibrating tools. So it is commonly seen in industries where work involves high force/pressure and the repetitive use of vibrating tools. gender is a more predictive risk factor for CTS than exposure to high-risk occupations. It affects females more often than males Also having arthritis or diabetes are risk factors. Having a parent, brother or sister with CTS and having previously injured to the wrist also increase risk on developing this condition
Several physical examination tests will help in the diagnosis of CTS but none of these tests is diagnostic on their own The patient with mild symptoms of CTS can be managed with conservative treatment, particularly local injection of steroids. Mild conditions can be recovered by physiotherapy treatments. However, in moderate to severe cases, surgery should be done. The basic principle of surgery is to increase the volume of the carpal tunnel by dividing transverse carpal ligament to release the pressure on the median nerve. Apart from early recovery and return to work there is no significant difference in terms of early and late complications and long-term pain relief between endoscopic and open carpal tunnel surgery
Symptoms of carpal tunnel syndrome can be reduced with physiotherapy treatment as well as a decompression surgery. Although Physiotherapy should be continued also after the surgery.
Nayani Sulakkhana
References
https://www.nhs.uk/conditions/carpal-tunnel-syndrome/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2397020/
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