Carpal tunnel syndrome is a hand and arm condition that causes numbness, tingling and other symptoms. Carpal tunnel syndrome is caused by a pinched nerve in your wrist.
Tests and diagnosis
A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems and possibly patterns of hand use.
Bound by bones and ligaments, the carpal tunnel is a narrow passageway located on the palm side of your wrist. This tunnel protects a main nerve to your hand and the nine tendons that bend your fingers.
Compression of the nerve produces the numbness, tingling and, eventually, hand weakness that characterize carpal tunnel syndrome.
Fortunately, for most people who develop carpal tunnel syndrome, proper treatment usually can relieve the tingling and numbness and restore wrist and hand function.
Carpal tunnel syndrome usually starts gradually with numbness or tingling in your thumb, index and middle fingers that comes and goes. This may be associated with discomfort in your wrist and hand. Common carpal tunnel syndrome symptoms include:
· Tingling or numbness. You may experience tingling and numbness in your fingers or hand, especially your thumb and index, middle or ring fingers, but not your little finger. This sensation often occurs while holding a steering wheel, phone or newspaper or, commonly, waking you from sleeping. The sensation may extend from your wrist up your arm.
Many people "shake out" their hands to try to relieve their symptoms. As the disorder progresses, the numb feeling may become constant.
· Weakness. You may experience weakness in your hand and a tendency to drop objects. This may be due to the numbness in your hand or weakness of the thumb's pinching muscles, which are controlled by the median nerve.
· Carpal tunnel syndrome occurs as a result of compression of the median nerve.
· The median nerve runs from your forearm through a passageway in your wrist (carpal tunnel) to your hand. It provides sensation to the palm side of your thumb and fingers, with the exception of your little finger. It also provides nerve signals to move the muscles around the base of your thumb (motor function).
· In general, anything that crowds irritates or compresses the median nerve in the carpal tunnel space can lead to carpal tunnel syndrome. For example, a wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation resulting from rheumatoid arthritis.
· In many cases, no single cause can be identified. It may be that a combination of risk factors contributes to the development of the condition.
Tests and diagnosis
the doctor may conduct one or more of the following tests to determine whether you have carpal tunnel syndrome:
· History of symptoms. Your doctor will review your symptoms. The pattern of your signs and symptoms may offer clues to their cause. For example, because the median nerve doesn't provide sensation to your little finger, symptoms in that finger may indicate a problem other than carpal tunnel syndrome.
Another clue is the timing of the symptoms. Usual times when you experience symptoms due to carpal tunnel syndrome include while holding a phone or a newspaper, gripping a steering wheel, or waking up during the night.
· Physical examination. Your doctor will conduct a physical examination. He or she will test the feeling in your fingers and the strength of the muscles in your hand.
Pressure on the median nerve at the wrist, produced by bending the wrist, tapping on the nerve or simply pressing on the nerve, can bring on the symptoms in many people.
· X-ray. Some doctors recommend an X-ray of the affected wrist to exclude other causes of wrist pain, such as arthritis or a fracture.
· Nerve conduction study. In a variation of electromyography, two electrodes are taped to your skin. A small shock is passed through the median nerve to see if electrical impulses are slowed in the carpal tunnel. This test may be used to diagnose your condition and rule out other conditions.
If the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome. Methods may include:
· Wrist splinting. A splint that holds your wrist still while you sleep can help relieve nighttime symptoms of tingling and numbness. Nocturnal splinting may be a good option if you're pregnant and have carpal tunnel syndrome.
If your symptoms are severe or persist after trying nonsurgical therapy, surgery may be the most appropriate option.
The goal of carpal tunnel surgery is to relieve pressure on your median nerve by cutting the ligament pressing on the nerve.
Medicines : homeopathic
Arnica: This remedy can be used for flare-ups of inflammation or new injuries caused
by repetitive use of the fingers and wrists. The area feels bruised and sore, and cramping may occur. External application of herbal Arnica lotion or ointment may help to ease the swelling and soreness, while other remedies are used internally.
Calcarea phosphorica: When this remedy is indicated, pain is felt in the bones and nerves of the wrists and arms, and stiffness and discomfort may also involve the neck. Cold and drafts often aggravate discomfort. The person may feel irritable and sensitive, or weak from overwork and pain.
Causticum: This remedy is useful when carpal tunnel syndrome is long-lasting or recurring. The area feels bruised, with drawing, burning pains. Stiffness and a feeling of weakness and contraction may be felt in the muscles of the hand and forearm. The condition is worse from getting cold and improved by warm applications. People who need this remedy often feel best in rainy weather.
Guaiacum: This remedy is indicated in carpal tunnel syndrome when the wrists (especially the left) are stiff with burning pain, and significantly relieved by applying ice or ice-cold water. Because of so much tightness, the person may feel a need to stretch the wrist, despite the pain.
Hypericum: This remedy may be useful if sharp or shooting pains are felt extending from the wrist. Hypericum is known for its soothing effect when body parts containing many nerves are injured, as well as in other traumatic nerve conditions.
Rhus toxicodendron: This remedy is useful when stiffness and pain are worse on initial motion and improve as movement continues. Overuse may lead to soreness, pain, and further stiffening. Discomfort is relieved by warmth and worse in cold, damp weather.
Ruta graveolens: This remedy is indicated when overuse of joints and irritation of nerves lead to tremendous stiffness. A feeling of bruising and lameness may be present, even when the wrist is allowed to rest. Weakness in the arms and wrists, especially after repetitive tasks causing wear and tear on the joints and nerves, often indicates Ruta.
Viola odorata: This remedy is useful for many conditions that involve the wrist and hand, especially the right. Pain and numbness may extend from the wrist through the hand and into the fingers, and the hands and arms may tremble. Symptoms are worse from getting cold.