Carpal Tunnel Syndrome: What It Is, Causes, Symptoms, and Treatment

The carpal tunnel is a channel structure in the wrist, surrounded by bones and various other connective tissue elements. The median nerve, responsible for functions related to the movement and sensation of the hand, passes through this tunnel.

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a neuropathic condition caused by the compression of the median nerve as it passes through this tunnel for various reasons. The median nerve is responsible for the sensation of the fingers, except for the ring and little fingers. Another function of this nerve is to carry electrical impulses to the muscles responsible for the movement of the thumb, thus contributing to motor functions.

What Causes Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome occurs as a result of pressure on the median nerve in the wrist area due to various diseases and anatomical changes. This pressure on the nerve is often caused by swelling in the connective tissue of the area and the disruption of blood flow.

Generally, factors such as genetic predisposition, repetitive movements involving the wrist, obesity, rheumatic diseases, and pregnancy are significant risk factors that can lead to increased pressure within the tunnel. Carpal Tunnel Syndrome is more commonly diagnosed in women than men.

There are many diseases associated with the development of Carpal Tunnel Syndrome:

• Diabetes
• Thyroid diseases
• Excessive fluid retention during pregnancy and menopause (fluid retention)
• Hypertension (high blood pressure)
• Autoimmune diseases, where the immune system causes damage to the body's own cells and tissues.
• Trauma in the wrist area.

Carpal Tunnel Syndrome typically does not develop due to a single cause. It is a condition that arises from the combination of health issues and risk factors that contribute to its development. One reason why it is more common in women than men could be that the tunnel is narrower in women than in men.

Various health problems, such as diabetes, can lead to nerve damage in the body. In diseases like rheumatoid arthritis, inflammation in the connective tissue in the region can lead to the development of Carpal Tunnel Syndrome.

The use of heavy machinery is another risk factor that may contribute to the development of Carpal Tunnel Syndrome. Prolonged exposure to intense vibration in the wrist over time can lead to the condition. Additionally, prolonged use of keyboards and mice in work environments can also be a contributing factor.

What Are the Symptoms of Carpal Tunnel Syndrome?

The symptoms of Carpal Tunnel Syndrome are linked to the normal functions of the median nerve, which is responsible for sensation and movement in the hand. When this nerve is affected, several symptoms may appear:

• Numbness, tingling, and pain in the thumb, index finger, and middle finger
• Pain and a feeling of heat spreading from the wrist up to the arm
• Wrist pain that wakes the person up at night
• Weakness in the hand muscles

The symptoms of Carpal Tunnel Syndrome generally develop gradually over time. It is important to note that the numbness and tingling do not affect the little finger. Occasionally, the sensation of numbness in other fingers may be accompanied by a feeling of electricity.

Some people may wake up at night due to wrist pain and instinctively feel the need to shake their wrists, expressing relief afterward. This could indicate the presence of Carpal Tunnel Syndrome.

A feeling of weakness is another symptom that may occur in individuals with Carpal Tunnel Syndrome. Patients may sometimes drop objects they are holding due to muscle weakness. In addition to weakness, muscle twitching can also be a symptom related to muscles in Carpal Tunnel Syndrome.

How is Carpal Tunnel Syndrome Diagnosed?

As with all diseases, the diagnostic approach for Carpal Tunnel Syndrome involves the patient’s medical history, physical examination, and the use of various diagnostic methods to confirm the diagnosis. It is important to inquire about the health conditions and work conditions that may contribute to the development of the syndrome during the medical history assessment.

During a physical examination, various tests may be performed to shed light on the presence of Carpal Tunnel Syndrome. The Tinel test involves tapping the carpal tunnel region with a reflex hammer. If symptoms associated with the median nerve are triggered, the test is considered positive.

The Phalen test is another important test applied during a physical examination for Carpal Tunnel diagnosis. In this test, the patient is asked to place the outer sides of their hands together in front of their body and hold this position for one minute. If symptoms like numbness, tingling, or pain appear during the test, it is considered positive.

The main diagnostic procedure for Carpal Tunnel Syndrome is electromyography (EMG), which examines the muscles and nerves responsible for stimulating those muscles in the affected area. Electrical signals transmitted from the nerves to the muscles are detected by the EMG device and documented numerically, allowing doctors to interpret the results.

How is Carpal Tunnel Syndrome Treated?

The treatment of Carpal Tunnel Syndrome can vary depending on the severity of the condition and the symptoms it causes.

If diagnosed early, Carpal Tunnel Syndrome can be controlled with supportive treatment and various recommendations. These may include educating the patient about wrist movements that may cause symptoms and advising them to avoid movements that stress the area.

Wrist splints, a medical product, help maintain the wrist in a normal position. They are particularly useful at night to prevent involuntary movements that could increase pressure on the wrist.

In cases where necessary, doctors may prescribe pain-relieving and anti-inflammatory medications to control swelling in the wrist area and alleviate pain. In some cases, steroid injections may be administered to the affected area to reduce inflammation.

In more advanced cases, surgical intervention may be required to treat Carpal Tunnel Syndrome. During this surgery, structures pressing on the median nerve in the wrist are identified and relieved to reduce pressure on the nerve.

In addition to Carpal Tunnel Syndrome treatment, various methods under the guidance and recommendation of doctors can help alleviate the symptoms associated with the condition:

• Carpal Tunnel Syndrome Exercises:
  An exercise where the hand is formed into a fist and then opened until the fingers are parallel to the floor, repeated 5-10 times, can help provide short-term relief in the wrist area.

  Another exercise involves swinging the hands in front of the body for 1 minute, approximately every 2 hours, which can also be beneficial for relieving symptoms.

• Carpal Tunnel Syndrome Braces:
  Wrist braces that help maintain the wrist in a neutral position can relieve pressure on the median nerve. These products are useful for avoiding movements that worsen symptoms during the day and preventing involuntary wrist movements at night.