Carpal tunnel is the narrow passage in the wrist through which the nerves and tendons, bones (8 bones), ligaments (carpal ligament), and blood vessels pass through. Carpal tunnel syndrome occurs when the nerve that runs in the carpal tunnel is compressed or squeezed at the wrist joint.
It is caused due to the pressure built on the median nerve and tendons. Certain factors that contribute to carpal tunnel syndrome are hereditary, fractures and sprains, hormonal problems, and other medical conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, and presence of cyst and tumor in carpal tunnel. Patients with carpal tunnel syndrome experience numbness and tingling sensation in all the fingers except little finger; pain and burning sensation in hand and wrist that may radiate up the arm and elbow; and weakness in hand with diminished grip strength.
Carpal tunnel syndrome can be treated by surgery or by nonsurgical techniques. The nonsurgical methods of treatment include:
Immobilization: Hand and wrist is immobilized using splint or cast for 4 to 6 weeks which prevents pressure on the nerves. Rest hand for 2 weeks or more and use ice packs to reduce swelling. Splints provide effective and good results if worn during night time, it helps to reduce numbness, tingling sensation, and pain.
Medicines: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen is taken orally to reduce swelling and provide relief from pain and inflammation. Corticosteroids such as prednisone or lidocaine are injected directly into the wrist. People with diabetes who are taking medicines should not continue to use corticosteroids without the doctor’s consent, as it may increase the insulin levels. Also, vitamin B6 (pyridoxine) supplements helps to provide relief from symptoms.
Rehabilitation program: It includes strengthening and stretching exercises that will promote healing. Physiotherapists will teach some of the exercises that should be followed on a regular basis. The exercises should be repeated four times a day through short and frequent session, instead of one long session. Exercises include holding the wrist and fingers straight and make a fist, touch each finger tip with your thumb, keep your palm on a table and spread fingers and bring them together (hold fingers and wrist straight). Repeat these exercises 5 times a day which may help you to regain the function and mobility of your hand. If your work demands excessive use of computer, then practicing stretching your wrist in middle of a break will help you to provide good relief.
Alternate therapy: It includes acupuncture and chiropractic therapy that may also help to treat carpal tunnel syndrome. Acupuncture is an alternate and oldest part of traditional Chinese medicine used for healing processes. It is performed by making defined points (or acupuncture points) on the skin and inserting thin sterile needles through it. However, only some patients are benefited with acupuncture. It also stimulates the nerve that transmits electrical impulses to the spinal cord and brain.
Treating underlying disease condition: The disease conditions that will worsen the carpal tunnel syndrome being diabetes and arthritis should be treated at first. For diabetes, regular monitoring and controlling the blood sugar levels helps to treat your condition. For arthritis, physical therapy, splints, and medicines are usually suggested by your surgeon.