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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Carpal Tunnel Syndrome

What is it?

Carpal tunnel syndrome results when the median nerve, which passes through a narrow tunnel of wrist bones (carpals) and a ligament at the base of the hand, is compressed by surrounding tissue or excess fluid. Symptoms, including numbness, tingling, and pain in the hand, wrist, or arm, may appear suddenly or gradually and often affect both hands. The disorder occurs most often among women between the ages of 30 and 60.

What Causes It?

  • Activities that require prolonged bending of the wrist or constant repeated hand motions may lead to carpal tunnel syndrome. Such activities include typing, assembly-line work, knitting, sewing, tennis, and canoeing.
  • Injury to the wrist may damage the median nerve.
  • Hormonal changes due to pregnancy or birth control pills may cause fluid accumulation in the carpal tunnel.
  • Diseases such as rheumatoid arthritis, diabetes mellitus, hypothyroidism, and acromegaly may promote carpal tunnel syndrome.

Prevention

  • Take frequent breaks when engaged in strenuous work or activities requiring repetitive hand motions, and try to vary activities so that wrists are not constantly bent.
  • Use a wrist-support pad while typing.

Diagnosis

  • Patient history and physical examination are needed.
  • The hands and wrists may be x-rayed.
  • A nerve conduction velocity study may be used to monitor the electrical impulses along the median nerve to determine if it is compressed.

How to Treat It

  • Over-the-counter analgesics can be used for pain.
  • A wrist splint may be prescribed, especially for nighttime use.
  • Diuretics may be prescribed to reduce fluid accumulation in swollen tissue.
  • Corticosteroids may be injected in more severe cases to reduce inflammation.
  • If symptoms persist despite treatment, surgery may be recommended to relieve pressure on the median nerve.

When to Call a Doctor

  • Call a doctor if symptoms of carpal tunnel syndrome become sufficiently troublesome or begin to interfere with normal daily activity.