Carpal Tunnel Syndrome (CTS) – Causes, Symptoms and Treatment

Carpal tunnel syndrome (CTS) is the condition that results from pinching of one of the nerves in the wrist and hand. The syndrome occurs more often in women and typically after age 30. Carpal tunnel syndrome is easily understood if one begins with the anatomy. The carpal tunnel is formed by a semi-circle of carpal bones on three sides. The fourth side that forms the carpal tunnel is the transverse carpal ligament. Any condition that causes swelling or a change in position of the tissue within the carpal tunnel can squeeze and irritate the median nerve. The result may be pain, weakness, or numbness in the hand and wrist, radiating up the arm.


The exact cause of the swelling usually is not known. Some studies suggest that carpal tunnel syndrome can result from overuse or strain in certain job tasks that require a combination of repetitive, forceful and awkward or stressed motions of your hands and wrists. It is most commonly caused by an injury to the wrist, the use of vibrating hand tools or rheumatoid arthritis, but it also has been linked to other causes, such as a cyst or tumor in the wrist.

Various conditions may alsoplay a role, such as:

* Repetitive, forceful grasping with the hands
* Repetitive bending of the wrist
* Harmonal changes
* Diabetes
* Thyroid imbalance
* Broken or dislocated bones in the wrist that cause swelling
* Pregnancy


The most common symptoms of carpal tunnel syndrome are tingling, numbness, weakness, or pain of the fingers or, less commonly, the palm. Symptoms most often occur in the parts of the hand supplied by the median nerve the thumb, index finger, middle finger, and half of the ring finger. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell between hot and cold by touch.


If carpal tunnel syndrome is caused by a medical problem, your doctor will probably first treat that problem. Treatments for carpal tunnel syndrome fall into two general categories: surgical and non surgical. Both have potential risks and benefits.

Initial treatment usually includes rest, immobilization of the wrist in a splint, and occasionally ice application. Patients whose occupations are aggravating the symptoms should modify their activities.

Endoscopic carpal tunnel surgery is performed on an outpatient basis utilizing a local anesthetic to numb the arm. After the procedure, a splint is applied to the wrist and the patient is discharged and allowed to go home.