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By Louis Neipris, M.D., HealthAtoZ writer
Carpal tunnel syndrome (CTS) is a painful condition in the wrist caused by the compression of the nerve running from the forearm to the hand. This nerve gets squeezed or pressed at the wrist and can cause pain, weakness and numbness in the wrist and hand. As symptoms worsen, you may have a tingling feeling and progressive weakness in your grip.
The doctor visit for CTS
Be ready to describe your symptoms and the nature of your job, hobbies and other activities in detail. Answer these questions before your visit:
- What am I doing when I feel the symptoms?
- Do the symptoms go away when I stop performing certain activities?
- What medical conditions do I have? (Diabetes, an underactive thyroid and other illnesses can predispose you to CTS.)
Your doctor will examine your hands, arms, shoulders and neck to try to determine the cause of your pain. Your doctor may also try to reproduce the symptoms by tapping or pressing on the nerve in your wrist to see if you experience any tingling sensation. Lightly tapping on your wrist or bending your wrist down for up to three minutes - two maneuvers that may bring a milder version of your symptoms - may also be done to help confirm the diagnosis of CTS.
Laboratory Tests
Nerve conduction study (NCS) and electromyography (EMG) are two tests that examine nerve and muscle, respectively. Damage to these structures can occur if CTS is not treated. These tests do cause some discomfort, so they are not done routinely unless your doctor has a good reason to believe you have CTS.
An NCS involves placement of electrodes on the skin of fingers and wrist. A tiny electrical current is passed through the nerve. Slowing of conduction through the median nerve in the carpal tunnel is evidence of CTS.
EMG involves insertion of a needle into a forearm muscle. Nerve damage may also be demonstrated if the muscle contracts abnormally.
Non-surgical treatment
Sometimes changing to better habits when you perform aggravating activities may help relieve CTS symptoms. However, if your symptoms are severe enough for you to see your doctor, your doctor may recommend that you use a wrist splint. You wear the splint at night to keep your wrist immobilized for several hours while you sleep. Immobilization allows the inflammation to subside and reduces or eliminates the pain that may be keeping you awake or waking you up at night. It may also be worn during the day and while doing any aggravating activities.
Anti-inflammatory medications work to block swelling, relieve pain and promote healing. Corticosteroids, such as lidocaine, may be injected into the wrist to help relieve pressure on the nerve. Prednisone taken by mouth will provide the same results. People with diabetes should inform their doctors prior to using these types of treatment.
If non-surgical treatment doesn't work, a surgical procedure called carpal tunnel release is used.
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This article was reviewed and updated June 2007.
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