Carpal tunnel syndrome is characterized by pain, burning / tingling sensation, numbness at the wrist, palm, thumb, index, middle & adjoining half of the ring finger. It is caused by the entrapment of the median nerve in a tunnel, called Carpal tunnel. Entrapment is caused by the inflammation of the synovial sheath covering flexor tendons at the wrist.
Pain, tingling and numbness in fingers are typically present on waking up. It can even wake up the patient from sleep.
The fingers feel swollen and intense aching is felt in the forearm. The symptoms may appear when the patient holds a newspaper, while steering the wheel of a car or holding objects in kitchen.
Sometimes it is seen in the third trimester of pregnancy which settles down on its own after delivery.
Tests and investigations —tapping the median nerve in the carpal tunnel or holding the wrist in forced Flexion may provoke symptoms.
Weakness in the grip of hands is also suggestive of the condition.
The carpal tunnel syndrome can be confirmed by US, MRI & CT scan. But they are usually not needed.
Management and injection technique — A splint worn on the wrist at night relieves or reduces the symptoms of carpal tunnel syndrome.
This is diagnostic and may be curative. Anti inflammatory & neurotropic drugs help in recovery. A corticosteroid injection into the carpal tunnel may also be considered. This often helps rapidly, although recurrence is common.
Surgical decompression of the median nerve is usually a permanent solution.