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A Primer on Carpal Tunnel Syndrome from Basil R. Besh, M.D.
Carpal tunnel is one of the most frequently talked about maladies and yet often misunderstood. Many will confuse manifestations of other hand and wrist complaints with carpal tunnel symptoms. Let’s take a few moments and discuss carpal tunnel syndrome.
What is carpal tunnel syndrome?
Carpal tunnel syndrome occurs when a nerve running through the wrist and palm becomes compressed. The nerve, called the median nerve, runs through a tunnel, called the carpal tunnel, at the base of the palm. Along with the nerve run nine tendons which connect the muscles in the forearm to the fingers. When these tendons swell, they take up all the room in the tunnel and increase pressure on the nerve. This causes three things to happen, tingling, numbness, and weakness.
How do I know when I have carpal tunnel syndrome?
The most common presentation of carpal tunnel syndrome is tingling in the hand which either occurs during the day or awakens one at night. Patients will often report that they need to shake the hand to make the tingling go away. At later stages, patients may complain of frequently dropping objects
What causes carpal tunnel syndrome?
There is no easy answer to this question. Most often the process is multifactorial, meaning there are several reasons. We know that there are many risk factors contributing to carpal tunnel syndrome including but not limited to diabetes, hypothyroidism, obesity, and pregnancy. Repetitive activity, vibration, and exposure to direct pressure on the palm have all been implicated in the development of carpal tunnel syndrome. Sometimes, there is no clear reason.
How can carpal tunnel syndrome be treated?
Early treatment consists of rest, activity modification, night splinting, and oral anti-inflammatories such as ibuprofen to shrink the swelling of the tendons. In advanced cases, a small procedure is done to open the tunnel to relieve the pressure on the nerve. Prolonged symptoms should be promptly brought to the attention of your healthcare provider.

