Wednesday, 13 April 2016

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a very common nerve entrapment neuropathy which causes irritation of the median nerve at the wrist. Half of the carpal tunnel syndrome cases reported symptoms of different severity in both wrists and hands. Compression and irritation of the median nerve when it travels under flexor retinaculum at the wrist often result in pain, numbness and tingling sensation along its distribution area. Carpal tunnel syndrome can be irritating or debilitating and the symptoms can cause a huge impact on the quality of daily life.

The cause of this syndrome is usually unknown but can be associated with certain conditions and injuries. Conditions that are commonly related to carpal tunnel syndrome include obesity, pregnancy, arthritis, hypothyroidism, diabetes mellitus and direct trauma. Overuse injury caused by repetitive maneuvers is a very common cause. There is limited space available at the wrist for the contents to pass through the wrist. Conditions that lead to swelling and inflammation at the wrist joint are more likely to irritate the median nerve that passes through the carpal tunnel.

Irritation of the median nerve may cause typical pain and paresthesias along the distribution of the median nerve, most commonly involve the thumb, index finger and middle finger. Pain and paresthesia may at times radiate into the forearm, arm and shoulder. Patients may claim that their fingers are swollen and useless. They may notice a loss of grip strength or weakness in the thumb. The flick sign – patients awaken by the pain and paresthesia at night may find that shaking the hand or flicking the wrist helps to alleviate the symptoms.

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