Carpal Tunnel Syndrome: A Comprehensive Guide to Numbness in the Hands

Experiencing hand numbness? – It could be Carpal Tunnel Syndrome (CTS), a common nerve disorder often behind such symptoms. This guide delves into the causes, symptoms, and treatments of CTS, from non-surgical methods to advanced surgical procedures.

Carpal tunnel syndrome (CTS) is a common neurological disorder that occurs when the median nerve, which runs from your forearm into the palm of the hand, becomes pressed or squeezed at the wrist. You may feel numbness, weakness, pain in your hand and wrist, and your fingers may become swollen and useless.

Understanding Hand Numbness: The Role of Nerve Compression

What is the cause?

Am I having a stroke? Am I having a heart attack…. These are the common questions patients ask when they experience numbness in the hand. There are numerous causes for numbness in the hands.

One of the cause of numbness in the hand is nerve entrapment (compression). The nerve can be either compressed at the spine region in the neck or anywhere along the nerves in the upper limb. Carpal Tunnel Syndrome (CTS) is one of the common causes of nerve compression in the hand.

In carpal tunnel syndrome, there is pressure over the Median nerve in the hand. This typically leads to numbness in the hands, specifically over the thumb, index, middle and ring fingers. The little finger is usually spared as it is supplied by a different

nerve. In long standing cases, patients also might complain of weakness of the thumb causing them to have a tendency of dropping things while using the hand. The numbness can be worse during the night while sleeping and at times wakes them up from sleep. Frequently patients also complain of pain in the fingers in addition to the numbness. This is due to the compression causing lack of blood supply to the nerves.

Patients usually find relief by shaking their hands vigorously.

The Role of Nerve Conduction Tests

Once the patient is suspected to have Carpal tunnel Syndrome, a Nerve Conduction Test can be done to confirm the diagnosis and assess the severity. In early onset of symptoms or mild cases, a trial of non surgical treatment can be advocated.

This includes use of a wrist splint, supplements, physiotherapy and a change or modification of activities.

If symptoms still persist after 3 months of non surgical treatment, surgery will be advised.

One of the main purpose of surgery is to prevent the condition from becoming worse. For moderate cases of Carpal tunnel Syndrome, surgery is the best option.

In patients with severe Carpal tunnel Syndrome, surgery is still advised but the patient might not recover completely due to irreversible damage to the nerve.

Since the introduction of Endoscopic carpal tunnel release (ECTR) in the 1980s, many studies have showed a high success rate for the procedure. Comparative clinical studies have showed that endoscopic carpal tunnel release resulted in less postoperative pain, faster recovery of grip and pinch strength, and earlier return to work compared with open methods.

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