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Carpal tunnel syndrome
Carpal tunnel syndrome is a specific group of symptoms including tingling, numbness, weakness, or pain in the fingers or hand and occasionally in the forearm and elbow. Bounded by bones and ligaments, the carpal tunnel is a narrow passageway - about as big around as your thumb - on the palm side of your wrist. This tunnel protects a main nerve (median nerve) to your hand and nine tendons that bend your fingers. Pressure placed on the nerve produces the numbness, pain and, eventually, hand weakness that characterize carpal tunnel syndrome. Fortunately, for most people who develop carpal
tunnel syndrome, proper treatment usually can
relieve the pain and numbness and restore normal use
of the wrists and hands.
Causes The cause of
carpal tunnel syndrome is pressure put on the median nerve. The median
nerve is a mixed nerve, meaning it has a sensory function and also
provides nerve signals to move your muscles (motor function). The median
nerve provides sensation to your thumb, index finger, middle finger and
the middle finger side of the ring finger. Pressure on the nerve can
stem from anything that reduces the space for it in the carpal tunnel.
Causes might include anything from bone spurs to the most common cause,
which is swelling or thickening of the lining and lubricating layer (synovium)
of the tendons in your carpal tunnel. The exact cause of
the swelling usually isn't known, but a variety of conditions and
factors can play a role. Some examples include rheumatoid arthritis,
certain hormonal disorders — such as diabetes, thyroid disorders and
menopause — fluid retention due to pregnancy, or deposits of amyloid, an
abnormal protein produced by cells in your bone marrow. Repetitive flexing
and extending of the tendons in the hands and wrists, particularly when
done forcefully and for prolonged periods without rest, also can
increase pressure within the carpal tunnel. Injury to your wrist can
cause swelling that exerts pressure on the median nerve. Physical
characteristics also may play a role. It may be that your carpal tunnel
is more narrow than average. Carpal tunnel syndrome may be associated
with people who have square wrists, where the width and thickness are
about the same, versus the more common rectangular wrist. Other less
common causes include a generalized nerve problem or pressure on the
median nerve at more than one location.
Risk factors Some studies
suggest that carpal tunnel syndrome can result from overuse or strain in
certain job tasks that require a combination of repetitive, forceful and
awkward or stressed motions of your hands and wrists. Examples of these
include using power tools — such as chippers, grinders, chain saws or
jackhammers — and heavy assembly line work, such as occurs in a
meatpacking plant. Some studies have also indicated that typing or
computer use may cause carpal tunnel syndrome, but the scientific
evidence for this is weak. Although it's not
clear which activities can cause carpal tunnel syndrome, if your work or
hobbies are hand-intensive — involving a combination of awkward,
repetitive wrist or finger motion, forceful pinching or gripping and
working with vibrating tools — you may be at higher risk of developing
the condition. Women are three
times as likely as men are to develop carpal tunnel syndrome. The
incidence in women peaks between the ages of 45 and 54, and the risk of
carpal tunnel syndrome also increases with age in men. Certain health
conditions can increase your risk, including some thyroid problems,
diabetes, obesity and rheumatoid arthritis. Women who are pregnant,
taking oral contraceptives or going through menopause also are at
increased risk, most likely due to hormonal changes. Fluid retention may
be a cause of carpal tunnel syndrome during pregnancy. Fortunately,
carpal tunnel syndrome related to pregnancy almost always improves after
childbirth. People who smoke cigarettes may experience worse symptoms
and slower recovery from carpal tunnel syndrome than nonsmokers do.
Carpal tunnel syndrome
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