Carpal Tunnel Syndrome (CTS)
Carpal Tunnel Syndrome (CTS) is the most common nerve compression disorder, affecting women three times more often than men. It occurs when the median nerve is compressed at the wrist as it passes through a narrow passage known as the carpal tunnel. The median nerve provides sensation to the thumb, index, middle, and half of the ring finger, and controls the muscles at the base of the thumb. Compression of this nerve disrupts these vital functions.
High-risk occupations: Farmers, heavy computer users, and athletes in sports that involve repetitive wrist movements.
Causes of CTS
- Physical Trauma: Wrist fractures or dislocations that put direct pressure on the median nerve.
- Repetitive Strain: Prolonged or repetitive wrist movements—such as gripping, excessive bending (flexion), or extending (extension)—and exposure to vibrating tools. These actions cause the tendons that control the fingers to swell and become inflamed. This swelling crowds the carpal tunnel and presses the median nerve against the transverse carpal ligament, leading to sensory loss and weakness.
Symptoms of CTS
In the early stages, patients experience wrist pain or numbness in the thumb, index, middle, and ring fingers. Some describe it as an "electric shock" sensation running to the fingertips. Symptoms are typically worse at night or early in the morning. Over time, numbness may become constant, accompanied by weakness, loss of grip strength, or frequently dropping objects.
Warning: If left untreated for a long period, it can lead to permanent muscle wasting (atrophy) at the base of the thumb.
Non-Surgical Treatments
Recommended for patients with mild symptoms and no muscle wasting:
- Avoiding activities that aggravate the median nerve.
- Taking non-steroidal anti-inflammatory drugs (NSAIDs) and Vitamin B supplements for nerve health.
- Local steroid injections to reduce nerve inflammation.
- Physical therapy.
- Wearing a wrist splint to keep the wrist in a neutral position and reduce pressure.
Surgical Treatment
Surgery aims to release the transverse carpal ligament, increasing the space in the carpal tunnel and relieving pressure on the median nerve.
Method 1: Open Release Surgery
Method 2: Endoscopic Carpal Tunnel Release (ECTR)
Post-surgery, the wound is dressed and supported with a splint. The splint can be removed for bathing and is typically taken off after one week, allowing for light activities. Most patients can return to normal hand usage after about one month of recovery.
Note: While surgery can effectively treat CTS, the condition can recur. Therefore, the best long-term prevention is adjusting your lifestyle and work habits to avoid excessive or repetitive strain on your wrists.
