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Carpal Tunnel Syndrome: A Cause of Hand Discomfort

Carpal Tunnel Syndrome (CTS) results from entrapment of the nerves which go from the wrists into the hands. The wrist contains many structures in close proximity, all of which pass through a very narrow area, not unlike a tunnel. When crowding of this "tunnel" occurs, the structures become compressed, and damage to the nerve results. The median nerve is most commonly involved. This nerve begins in the neck, runs through the arm, and into the hand. It supplies movement and feeling for the thumb, the index finger, and part of the middle finger. Burning, tingling, and numbness of the fingers, often at night, are the usual symptoms of CTS. This discomfort may initially be relieved by shaking or exercising the hand. Some patients also find that the numbness radiates up the arm. If left untreated for long periods of time, weakness, loss of muscle in the hand, or even paralysis may occur.

Inflammation or swelling of the structures within the wrist often produce this syndrome. The more common causes include: arthritis, tendinitis, thyroid disease, injury to the wrist, and even fluid retention associated with pregnancy. Due to its frequent association with arthritis and inflammation, carpal tunnel syndrome is considered a rheumatologic disorder.

Once a diagnosis of CTS has been established, the initial treatment is often conservative. Included in the treatment is the use of anti-inflammatory medications and splinting of the wrist at night. If these measures should fail, an injection of medication into the area is often helpful. In the non-responsive forms of this disorder, surgery may be a consideration.



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