Carpal tunnel syndrome is a common condition affecting a nerve in front of the wrist, which gets compressed as it passes through a tight space (Carpal Tunnel). It commonly presents with feeling of tingling, numbness and pain in the hands and may result in weakness of grip. The symptoms may be intermittent initially but may become troublesome later.
Even though the condition is fairly common, sometimes there are challenges in accurate diagnosis. It is important to rule out many other conditions around the wrist that may present like carpal tunnel syndrome. The same nerve maybe compressed at a different location in the arm, or in the neck with somewhat similar presentation. The diagnosis is largely based on clinical examination, however additional help maybe sought with nerve conduction studies. To rule out other conditions, confirm suspicion diagnosis or to assess the result of surgery.
Frequently there is no obvious cause but sometimes hormones,inflammatory conditions or injury may lower the threshold to get symptoms.
Splints: In the initial stages, use of the splint to be worn in the night may help the symptoms as it aims to prevent abnormal wrist positioning during sleep.
Steroid injection: injection of steroid may temporarily relieve symptoms and sometimes can be a predictive of the result of surgery later on. However repeated injections of steroids should be avoided to minimise complications.
Surgery: Splints or injections may sometimes control early and mild symptoms. On the other hand persistent and severe symptoms warrant surgical release. This operation can be done under local anesthesia to relieve compression of the nerve. The conventional open technique involves an incision in front of the wrist. The more modern technique involves use of an endoscope through a tiny incision. This has been proven to allow early recovery.