This syndrome (which is a collection of symptoms) occurs when the median nerve becomes compressed, resulting in pain and numbness. This nerve, along with the tendons that move the fingers, goes through an anatomic area on the palm side of the hand called the carpal tunnel.
In the diagrams above, the carpal tunnel is the space under the transverse carpal ligament, which forms the roof of the carpal tunnel space. The walls and floor of this tunnel are formed by the wrist bones. Nine tendons and their surrounding synovium (gliding membranes) and one nerve (median nerve) pass through this tunnel. When the median nerve gets compressed or inflamed, symptoms can occur which include numbness and/or pain in the areas supplied by the median nerve. If the median nerve is irritable, numbness and pain symptoms can be reproduced by tapping on the nerve. This test is called the Tinel’s sign.
Carpal tunnel syndrome is more common in patients who
--do repetitive work,
--have diabetes,
--have thyroid disease,
--struggle with obesity,
--and also occurs more commonly during pregnancy.
Carpal tunnel syndrome can be confirmed with electodiagnostic nerve tests, although sometimes these tests can be falsely negative (meaning the patient has carpal tunnel syndrome but the nerve test is inconclusive).
Non-operative: rest, splinting, anti-inflammatory medications, injections
Operative: carpal tunnel surgery (the transverse carpal ligament is released), usually an outpatient procedure. After surgery, the dressing from the hospital is kept on for about a week, then a wrist splint is worn for an additional three weeks.