Carpal Tunnel Syndrome: Neuropathy Of The Hands

Today's very informative post from mmcneuro.wordpress.com (see link below) talks about something that confuses many people who don't see their nerve problems as being a form of neuropathy. Remember the word 'neuropathy' just means 'nerve damage' and there are over 100 forms and over 100 causes. Carpal Tunnel Syndrome is one of those and is much more common than you think and can be caused by such diverse things as manual labour, pregnancy and even long-term computer work. As it says at the end of the article, if you suspect you may have Carpal Tunnel syndrome, consult your doctor and if necessary a neurologist. It is also possible to get Carpal Tunnel Syndrome while also having other forms of neuropathy, or other diseases, so if you think this article is not for you, it's always worth while boning up on your knowledge of how nerves work.


Numb tingling hands, it’s probably carpal tunnel syndrome

March 22, 2013

Numbness and tingling in the hands is most often from Carpal tunnel syndrome (CTS).

CTS is caused by compression of the median nerve as it travels across the wrist with the tendons between the carpal bones and the flexor retinaculum (also known as the transverse carpal ligament):

CTS is caused by compression of the median nerve under the flexor retinaculum also known as transverse carpal ligament.

Compression an injury to the median nerve causes numbness and tingling mostly affecting the thumb, index finger, middle finger, and half of the ring finger.

CTS usually causes numbness and tingling mostly in the thumb, index and middle fingers

More severe cases also cause weakness and wasting of the muscle at the base of the thumb that abducts the thumb away from the fingers (abductor pollicis brevis or APB):

Thumb abduction, the movement that is weak in more severe cases of CTS, where there is involvement of both motor and sensory median nerve fibers.

Wasting of APB muscle belly (“thenar eminence”) in severe CTS
In severe cases, the numbness can seem to affect the whole hand, and can even radiate up the forearm and arm:

Symptoms are often worse typing, driving, and frequently wake the affected patient up at night:

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CTS can usually be diagnosed on clinical grounds. A helpful physical finding is a tingling in the wrist and fingers caused by a tap over the carpal tunnel (Tinel’s sign):

In some cases, an electrodiagnostic study may be necessary to confirm the diagnosis:

CTS is usually “idiopathic” (we don’t know why it happened), but some cases are caused by diabetes,pregnancy, thyroid disease, joint swelling from rheumatoid arthritis, heavy manual work and work with vibrating tools.

Treatment usually begins with conservative measures, like avoiding exacerbating activities, and wearing a neutral position night splint:

Patients who do not improve with these conservative measures can undergo a surgical procedure to release the compressed median nerve:

Want to find out more?
Click here to take an on-line quiz to see if you have CTS.

Watch this on-line video tutorial explaining the causes and treatment of CTS:

If you think you might have CTS, you should make an appointment to see a neurologist.

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