Carpal
tunnel syndrome is quite a common complaint, typically found
in middle-aged women, in which there is weakness, numbness and
pain in the hand. The carpal tunnel is a space between the carpal
bones in the wrist and the tissues, mainly tendons, above. Through
the tunnel passes the median nerve, a vital nerve for the working
of the hand. In the carpal tunnel syndrome, the median nerve
becomes compressed within the carpal tunnel. The cause is usually
unknown though such conditions as rheumatoid arthritis, hypothyroidism
(see Thyroid problems) and pregnancy are sometimes involved.
The pain and numbness is classically felt in the index and middle
fingers and there can be marked, disabling weakness of the thumb.
It is common for people with this condition to wake up in the
middle of the night with a severe bursting or burning pain in
the hand, sometimes the whole lower arm. Very often the sufferer
will get out of bed shake the hand vigorously and put it under
the cold tap. Both measures help a little. To help the doctor
diagnose the condition when the pain isn't present, flexing
the wrist at a right angle for a little while will bring the
pain on in the majority of cases.
Sometimes the condition is transient or occasional but, if more troublesome, wrist splints, particularly to be worn at night, may give some relief. Because there is an association with fluid retention, diuretics can sometimes help. Many doctors, seeing anybody with carpal tunnel syndrome, will carry out a blood test for hypothyroidism of which, carpal tunnel syndrome, can, sometimes, be an early sign. Many doctors will give an injection of corticosteroid into the carpal tunnel with the intention of reducing any swelling that may be present. If the condition is not helped by any of these then an operation of decompression of the carpal tunnel may be carried out. This, unfortunately, is not always successful neither will it always show physical compression of the median nerve. |
