Our bodies are amazing things, but from time to time, things can go wrong. Modern life – sitting down all day, lying on the sofa – means sometimes we use our bodies in ways they’re not designed for, which can cause all kinds of aches and pains.
Carpal tunnel syndrome is one of the most common nerve problems among adults, affecting between three and six percent of the population worldwide. Many doctors believe that cases are on the rise due to the increased use of smartphones and laptops.
Here, Dr. Subhash Jangid, Director and Head of Department of Bone and Joint Institute (Fortis Memorial Research Institute) says, “More and more people are getting diagnosed with carpal tunnel syndrome. There has been an increased use of media devices such as mobile phones, laptops, computers and video games because of the study- and work-from-home situation due to covid restrictions. The use of the thumb and fingers has increased significantly while holding a device in hand which is causing increased and repetitive pressure on the carpal tunnel.”
He adds, “Recently, after the second wave of covid hit, I have seen the number of people with symptoms of carpal tunnel syndrome almost double that of what we used to see in the pre-covid era.”
In this article, Dr. Subhash explains what carpal tunnel syndrome is, how it’s diagnosed and what we can do about it.
Carpal tunnel syndrome is a condition affecting your median nerve, a major nerve in your wrist. This can get compressed in the carpal tunnel – the narrow passageway inside your wrist through which several nerves and tendons travel to your hands and fingers.
Dr. Subhash explains further, saying, “With this condition, the median nerve of our upper limb, which is one of the major nerves for the functioning of our hand, is compressed under a tunnel at the level of the wrist joint. This tunnel is made of bones on one side and a strong bridge made of fibrous tissue on the other side. Due to the rigidity of these structures, any increase in the volume of the contents of the tunnel puts pressure on the most sensitive organ in the tunnel – the median nerve. This pressure causes the nerve to get compressed, which leads to symptoms in the thumb and the fingers.”
There are a number of things that happen when the nerve is being compressed, including numbness, pain, pins and needles, weakness and tingling. Often, these symptoms are worse at night or when carrying out certain activities. As we sleep we tend to curl our hands, this compresses the nerve more and causes even more pain. “The entire hand can be affected but sufferers usually have classic symptoms on the median nerve. This results in sensations in the thumb, index finger, middle finger and half of the ring finger. When it is left untreated, it can lead to the wasting of the muscles supplied by the nerve – this is usually the big muscles of the thumb,” says Dr. Subash.
Over time, occasional symptoms can become worse and lead to loss of strength and weakness in the fingers and thumb. It is important to seek timely treatment as irreversible damage could occur. The sooner it is treated the more likely you are to recover fully.
Often there is no specific reason, although there is a significant genetic predisposition to the condition, which means if your parents have had it you’re more likely to as well. It’s also more common in women. Pregnant women are also more likely to develop it as fluid retention can compress the nerve even more.
Dr. Subash adds, “There are plenty of causes for this disease. The common ones are diabetes, hypothyroidism, renal failure, liver diseases and pregnancy. Many times there is no specific reason for this disease. In these cases, the tunnel is either very small as compared to a normal person or because of repetitive stress on the roof of the tunnel it becomes thick and hard and that can lead to pressure on the nerve. The condition generally affects women more commonly than men. People who are obese and those who use their hands for excessive typing and texting are commonly affected by this disease.”
How do you go about getting a diagnosis if you have these symptoms? There are a number of tests your doctor will carry out in order to determine whether it’s carpal tunnel syndrome.
Tinells test: This is a classic nerve test where a doctor taps on the nerve of the wrist and it will send an electric shock-type response through the wrist.
The Phalens test: A doctor will bend the wrist to see if the symptoms worsen or appear.
The Durkan’s test: A doctor will compress the nerves to see whether it exacerbates the symptoms.
Nerve conduction studies (NCV) may also be carried out to see whether the nerve conduction is slowing across the wrist, which can also add to the diagnosis.
If you’ve been diagnosed with carpal tunnel syndrome, there are a number of treatments that may be suggested, ranging from the least to the most invasive procedures.
Lifestyle changes: Sometimes a modification in lifestyle – such as reducing the amount of typing or repeated pressure you’re putting on your wrist – can be enough.
Splints: These keep the hands straight and reduce pressure on the nerve, especially at night.
Steroids: Steroid injections around the nerve can reduce inflammation and pain, often in conjunction with ultrasound.
Surgery: This is the most invasive, and involves the surgeon releasing the tight roof of the carpal tunnel in order to release the pressure. The operation only takes between five and 10 minutes, and improvement is often immediate and permanent, although it can take up to five weeks depending on the severity of the problem.
Taking timely action if you develop symptoms of carpal tunnel syndrome is extremely important to ensure complete recovery. Always keep on top of your health by being aware of your body, monitoring symptoms, getting good health insurance and going for timely check-ups. It is the best way to make sure that diseases and conditions, when if they do arise, can be nipped in the bud with appropriate treatment.
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