1. What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome occurs due to abnormalities in the anatomical structure of the carpal tunnel—a narrow passage approximately 2.5 cm wide that protects the median nerve. The floor and sides of the tunnel are formed by carpal bones, while the roof is covered by a strong connective tissue band called the transverse carpal ligament.
Inside the carpal tunnel run the median nerve and the flexor tendons of the fingers, originating from the forearm. Because the tunnel is a tight, rigid space without room to expand, the median nerve — which is soft and lies closest to the surface — is vulnerable to compression.
The median nerve is a major nerve of the hand, arising from cervical spinal nerve roots. It runs along the arm and forearm, passing through the carpal tunnel into the hand.
The median nerve provides sensation to the thumb, index finger, middle finger, and part of the ring finger. It also controls the muscles around the base of the thumb. Compression leads to impaired function, causing symptoms of carpal tunnel syndrome.
2. Symptoms of Carpal Tunnel Syndrome
If a patient suddenly experiences numbness, tingling, or weakness in the hand, worsening over time, CTS should be suspected.
Common symptoms include:
- A sensation of swollen fingers without visible swelling
- Numbness, tingling, burning, and pain mainly in the thumb,index, middle, and part of the ring finger; sometimes symptoms radiate to the forearm and arm
- Pain or tingling spreading from the forearm to the shoulder
- In advanced cases, hand weakness, clumsiness, muscle pain, and cramps, causing difficulty in everyday activities like gripping objects, buttoning clothes, using a phone, driving, or reading
- Dropping objects due to numbness and loss of spatial control of the hand
Symptoms usually develop gradually without a specific injury. They often worsen at night when the wrist is bent during sleep, increasing pressure on the median nerve.
Early symptoms are often transient and unrecognized until they become frequent or persistent, by which time median nerve compression is severe.
3. Causes of Carpal Tunnel Syndrome
CTS results from multiple factors. Studies show higher prevalence in women and older adults.
Causes include:
- Genetics: Some ethnic groups have smaller carpal tunnels or anatomical variations that narrow the space, increasing nerve compression risk.
- Gender: Women are three times more likely to develop CTS due to smaller carpal tunnel size.
- Repetitive hand use: Repeated movements of the wrist and hand over long periods can injure wrist tendons, causing inflammation and nerve compression.
- Wrist position: Frequent bending or overextension of the wrist increases pressure on the median nerve.
- Pregnancy: Hormonal changes can cause swelling and inflammation inside the carpal tunnel.
Associated medical conditions: Obesity, diabetes, rheumatoid arthritis, kidney failure, and thyroid disorders are linked to CTS. - Wrist injuries: Conditions like arthritis, ligament inflammation, nerve inflammation, dislocations, or fractures can reduce carpal tunnel space and compress the nerve.
4. High-Risk Groups
CTS symptoms often become noticeable during routine activities, especially those involving repetitive wrist movements, such as:
- Assembly line workers
- Drivers
- Craftsmen
- Bakers
- Hairdressers
- Cashiers
- Secretaries and typists
- Musicians
However, scientific evidence remains inconclusive about whether these activities are direct causes or risk factors.
5. Is Carpal Tunnel Syndrome Dangerous?
Mild CTS symptoms may resolve in days with normal hand function restored. In severe or prolonged cases, symptoms worsen, causing:
- Carpal tunnel narrowing
- Pain, numbness, or loss of sensation in the hand
- Muscle atrophy in the thumb area
- Reduced hand mobility and function
6. Treatment Methods
Treatment options include:
- Wrist splints: Maintain the wrist in a neutral position to reduce pressure on the median nerve.
- Pain relief and anti-inflammatory medications: Drugs like paracetamol or ibuprofen are used short-term under medical supervision to avoid side effects.
- Surgery: For severe cases, cutting the transverse carpal ligament increases tunnel space and relieves nerve and tendon compression.
- Physical therapy: Exercises, yoga, ultrasound therapy, and acupuncture can reduce pain and strengthen hand muscles.
- Chiropractic care: Spinal nerve therapy is an effective and safe treatment option.
If you experience numbness, tingling, or pain in your fingers, consider the possibility of carpal tunnel syndrome. Awareness can lead to early diagnosis and proper medical care, along with adjustments in daily activities to reduce symptoms.
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