Carpal Tunnel Syndrome - Symptoms and Early Signs

What Is Carpal Tunnel Syndrome? Diagnosis & Relief Options

Carpal tunnel syndrome symptoms usually begin subtly with tingling, numbness, and burning sensations in the index finger, thumb, middle finger, and sometimes the ring finger. These symptoms mostly appear at night, causing difficulties in sleeping.

Introduction

Carpal tunnel syndrome (CTS) occurs when the median nerve is compressed while passing through the carpal tunnel. This tunnel is a narrow opening in the wrist adjacent to the transverse carpal ligament across the upper area of your wrist. This nerve provides motor and sensory functions to your 3 middle fingers and thumb. If it gets compressed, it can give rise to symptoms.  

What Causes Carpal Tunnel Syndrome (CTS)?

Primarily, if there is increased pressure within this carpal tunnel, it can compress the median nerve while it passes across your wrist through this carpal tunnel. Typically, various factors play different roles in developing pressure on this particular nerve. These are as follows:

1.Anatomical Differences and Changes

1. The opening of this tunnel is extremely narrow, which may affect someone with a smaller size of tunnel opening than the average.
2. Women generally have a smaller and narrower carpal tunnel than men, which is why they are susceptible to developing these syndromes.
    

2.Inflammation and Swelling

In case of swelling in and around the tissues of the carpal tunnel, it can press the median nerve. Inflammation or swelling may occur due to various reasons, like:

1. Continuous hand movement with or without minimal rest.
2. Long-term and frequent flexing of the wrist for a longer time can lead to CTS development.
3. Conditions like rheumatoid arthritis can cause joint inflammation, triggering the pain.   
    

3.Injuries

1. Sudden wrist injuries, including dislocation, break, sprain, or strain, can cause CTS, making it difficult to move the wrists.
2. Injuries are the main risk factors of carpal tunnel syndrome, and they fully hamper daily activities.  
    

4.Blood Sugar Levels

1. Obesity and diabetes, due to metabolic or hormonal changes in the body, can lead to this problem.
2. Thyroid imbalance also increases blood sugar, which can result in weight gain.
3. Prolonged pressure on the wrists due to obesity can worsen the condition.  
    

What are the signs and symptoms of CTS?

Symptoms of carpal tunnel primarily cause numbness, pain, and tingling in the fingers and hands. Here we will discuss the symptoms in detail, as follows:

1.Numbness and Tingling

The median nerve is important in the hands and wrists. Sometimes, it creates a sensation of swollen fingers, despite not being swollen.  

1. Early signs of CTS are tingling and numbness in the wrist and fingers due to increased pressure on this nerve.
2. After the compression of this nerve, it disrupts these signal pathways, leading to numbness and tingling. This sensation mainly occurs in the index, middle, and thumb.   
    

2.Pain in the Wrist and Fingers

This nerve provides feelings to the index finger, thumb, and middle fingers, along with the part of the ring finger.

1. Additionally, it controls certain small muscles at the base of the thumb and all wrist movements.  
2. This nerve passes through the carpal tunnel, along with the finger tendons, and excessive compression can cause pain in the fingers and wrists.  
    

3.Night time Symptoms

CTS symptoms worsen at night because many people sleep with their wrists bent, either on the left or the right side.

1. Sleeping on the side reduces the space of the carpal tunnel and exacerbates the compression, leading to intense pain and numbness in the hand.
2. Fluid retention during the nighttime can increase swelling in the wrist, leading to further compression of the median nerve.   
    

4.Impaired Sleep

Irregular sleeping positions can worsen the wrist pain, leading to sleep disturbances.

1. Frequent worsening of pain during nighttime can lead to irregularities in the sleep cycle.
2. Improper flexing or wrist bending can cause frequent awakening, making it difficult to fall asleep again properly.
    

5.Weakness and Clumsiness

Nerve signals regulate the motor tasks of our wrists and fingers. Compression can lead to loss of function of many sensory nerve fibres.  

1. Symptoms like weakness and clumsiness occur if this nerve gets compressed for a prolonged period.
2. Compression of this nerve leads to loss of sensation, as it cannot send proper signals effectively, making it difficult to grip objects or do any household tasks.  
    

What Are Some Diagnostic Tests for Carpal Tunnel Syndrome?

Diagnostic tests for carpal tunnel syndrome focus on the normal functioning of the median nerve and ruling out other causes of wrist and hand pain.

Here we will discuss the diagnostic tests to detect carpal tunnel syndrome:

• Physical Examination: Through physical tests, doctors assess symptoms of CTS and the strength of the wrists. Mainly, it is done to check two important considerations of nerve compression, including Tinel's sign and Phalen's test (numbness or tingling with wrist flexion).   
• Nerve Conduction Study: NCS, or Nerve Conduction Study, measures and monitors the rate at which electrical impulses travel through the nerve. The transmission speed of the neural signals helps experts assess the proper functioning of the nerve.  
• Electromyography: This test completely evaluates the electrical activities of the hand muscles and provides information about nerve-muscle function. It can confirm any kind of median nerve compression and any kind of muscular tissue disorders, such as myopathies.
• Ultrasound: This diagnostic test allows doctors to get a clear visualisation of the median nerve and the flexor retinaculum (ligament that covers the carpal tunnel). It can capture any kind of protrusion of ligaments, which can be an indication of CTS.  
• Magnetic Resonance Imaging (MRI): MRI allows doctors to see if there is any compression on the median nerve, which is a key indication of CTS. Apart from compression, it can provide a detailed image of any kind of fluid retention in the carpal tunnel, where excessive fluid can worsen carpal tunnel syndrome.

What Are Some Common Treatment Methods for Carpal Tunnel Syndrome?

Healthcare experts can treat these symptoms of carpal tunnel syndrome with both surgical and non-surgical methods.

Here we will discuss some common treatments for CTS:

Non-surgical Treatments

1. Splinting: Wearing a wrist splint during bedtime can keep the wrist in a neutral position.
2. Pain Medications: Pain relievers like ibuprofen or naproxen can manage the inflammation and pain.
3. Corticosteroid Injections: Direct injection of corticosteroids into the carpal tunnel can reduce swelling and inflammation.
4. Exercise: Doing regular freehand exercises can manage numbness and tingling of the hands.
    

Surgical Treatments

1. Endoscopic Surgery: A minimally invasive technique to operate on ligaments wrapping around this tunnel.
2. Carpal Tunnel Release Surgery: It involves a surgical operation on the transverse carpal ligament to enlarge this tunnel, leading to relief from pressure on this particular nerve.  
    

Final Takeaway

Carpal tunnel syndrome is common in adults who have thyroid imbalance and diabetes. It is generally worse during nighttime while sleeping. Common symptoms of CTS are tingling and numbness in the wrists and fingers.

Seeking medical help can help manage pain and reduce inflammation. In complicated cases, you can go for surgical methods to recover permanently.