Carpal tunnel syndrome (CTS)
CTS is caused by compression of the median nerve within the carpal tunnel. It is the most common compression neuropathy of the upper extremity. The compression is caused by swelling, fracture, joint dislocation, or inflammatory arthritis. Awkward wrist positioning during repetitive activities such as childcare or work is often associated with this condition.
Symptoms of CTS
- Numbness on the inside of the thumb, index and ring fingers
- Atrophy of the thumb muscles
- Difficulty with fine motor tasks
- Dull, aching discomfort in the forearm or upper arm may occur in up to 45% of patients and is associated with milder carpal tunnel syndrome
Other diseases that can mimic carpal tunnel syndrome include:
- Anterior interosseous nerve syndrome
- C6 or C7 radiculopathy
- Pronator syndrome
- Supracondylar process syndrome
Your problem will be evaluated by gathering information with a complete and detailed medical history followed by a focused physical examination. Diagnostic studies confirm your diagnosis. These specialized tests may include x-ray, CT, electrodiagnostic (EMG) studies, ultrasonography, or MRI. Treatment will depend on the source of pain. Options include different oral medications, physical therapies and targeted injections. It is important to remember that at a 2-year follow up of untreated carpal tunnel syndrome, 67% of patients remained the same electrodiagnostically with almost 8% deteriorating and 25% improving. So the most important first step is to avoid repetitive wrist and hand movements to start the healing process. This can be followed by wrist splints at a neutral angle which are most effective when used within three months of symptom onset. Wrist splints only at night are not as effective as full-time use.