Carpal Tunnel Syndrome (CTS)

This well-known condition results when the median nerve that runs through the arm is compressed by a small space in the wrist which is called the carpal tunnel.  The carpal tunnel is a slim tube located on the palm side of the wrist which encases a nerve and several tendons that run into the hand. The compression is caused by swelling or anything that decreases the size of the carpal tunnel.  The median nerve controls the movement of the thumb and the first three fingers; pain, tingling, numbness, and weakness in these areas are symptomatic of the syndrome.  The swelling itself may be caused by a variety of conditions, like hypothyroidism, rheumatoid arthritis, diabetes, pregnancy, obesity, and even smoking, which reduces blood flow to the median nerve.  Commonly, repetitive hand movements, wrist injuries, and bone spurs also cause the condition.

If left untreated, the muscles of the hand may waste away or atrophy, more severe cramping will develop, and the median nerve will begin to deteriorate, causing loss of feeling, hand strength, and coordination around the thumb.  Permanent damage to the muscles and the hand will result.

The onset of Carpal tunnel syndrome is associated with several factors, including:

• Anatomical factors, such as wrist fracture or dislocation, and narrower carpal tunnels (common in women).
• Nerve-damaging conditions, such as diabetes and alcoholism
• Inflammatory conditions, including infections and rheumatoid arthritis
• Changes in body fluids balance, caused by pregnancy, menopause, obesity, thyroid disorders, and kidney failure
• Workplace factors, particularly prolonged or repetitive flexing of the wrist, and prolonged exposure to vibrations

In our office, we have several solutions for those who suffer from carpal tunnel syndrome.  We offer cortisone injections and prolotherapy injections with or without ultrasound guidance. We also suggest using wrist splints at night and prescribe medications. If required, we refer patients for carpal tunnel release surgery. We also offer physiotherapy, active exercises, TENS,  MET, ultrasound, and IFC, as well as acupuncture and auricular acupuncture.  From the psychological perspective, we offer biofeedback and psychotherapy.

Source: http://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome-topic-overview.