Hand > Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow, rigid gap between your wrist bones (carpal bones) and the ligament that holds them together (transverse carpal ligament). A ligament is a rope which connects two bones together. Your median nerve and nine flexor tendons run through the carpal tunnel and into your hand, and enable you to move and feel your fingers. If any of these nerves or tendons are overused or irritated, they can swell, which can cause pressure inside the carpal tunnel. This pinches the nerve at the level of the wrist and is called carpal tunnel syndrome.

Carpal tunnel syndrome is not normally considered a sports injury, though it can affect your athletic performance. It is a repetitive strain injury, and is usually the result of overuse, and misuse, of your hands, wrists, and arms. Anyone who regularly performs an activity that demands the same series of movements over and over is vulnerable to a repetitive stress injury, particularly if the wrist is constantly being flexed or extended. Athletes who pursue certain sports such as bowling, or people whose jobs require repeated motions, such as work at a computer, on an assembly line, or with vibrating tools, are at increased risk of suffering carpal tunnel syndrome. It can also be associated with certain illnesses such as diabetes, renal failure and thyroid condition. Previous injury to the wrist such as a wrist fracture, torn wrist ligaments, or arthritis can also increase your risk for developing carpal tunnel syndrome.

Pain or numbness in your wrists, hands, forearms, or elbows may not necessarily be caused by carpal tunnel syndrome. Nerves can be pinched in other places, which can cause numbness in the hands. Other common locations include: the forearm, neck and spine. Be sure to describe your symptoms in detail to your physician so that an accurate diagnosis can be made and the proper treatment administered.

There usually are three parts to an orthopedic evaluation: medical history, a physical examination, and tests that your physician may order.

Your physician will ask about your activities, which may have caused your pain. You will be asked when the pain began, where it occurs, how long it lasts, and what lessens or worsens it. It is vital that you describe in detail your symptoms, and particularly, what motions you perform regularly at work or in athletic activities that affect your wrist and hand. Physicians also typically ask about other conditions, such as arthritis, diabetes, and allergies, and medications currently being taken. You may also be asked about your physical and athletic goals – information that will help your physician decide what treatment might be best for you in achieving those goals.

The most common physical test your physician may perform to determine if you are suffering from carpal tunnel syndrome is a wrist flexion test. In this test, your wrist is placed in complete flexion (as if you were trying to touch the base of your palm with your ring finger) for as long as a minute. Another test, called Tinel’s tapping test, involves your physician tapping the area around your wrist with his finger. If the tapping produces tingling or an electric shock-type sensation along the median nerve, carpal tunnel syndrome is likely indicated.

TESTS

In some cases, your physician may conduct a nerve conduction velocity test, which measure how fast impulses are conducted through the median nerve. This involves placing electrodes on your skin or needles in your muscles. The structure is then stimulated with a small dose of electricity. The physician then measures how long this impulse takes to travel to its receptor. This allows him to determine the velocity of the impulse along the nerve which is analagous to a car’s speedometer. The faster the velocity the healthier the nerve.