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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.
When to seek medical advice If signs and
symptoms that you think might be due to carpal tunnel syndrome interfere
with your normal activities — including sleep — and they persist, see
your doctor. If you leave the condition untreated, nerve and muscle
damage can occur.
Screening and diagnosis Your
doctor will most likely want to review your signs and symptoms to find
out where they're located. One diagnostic key is that the median nerve
doesn't provide sensation to your little fingers. Another clue is the
timing of the symptoms. Typical times when you might experience symptoms
due to carpal tunnel syndrome include while holding a phone or a
newspaper, gripping a steering wheel, or sleeping. Your doctor will also
want to test the feeling in your fingers and the strength of the muscles
in your hand, because these can be affected by carpal tunnel syndrome.
Pressure on the median nerve at the wrist, produced by either bending
the wrist, tapping on the nerve or simply pressing on the nerve, can
bring on the symptoms in many people. If you
have signs and symptoms of carpal tunnel syndrome, your doctor may
recommend the following diagnostic tests:
Electromyogram.
Electromyography measures the tiny electrical discharges produced in
muscles. A thin-needle electrode is inserted into the muscles your
doctor wants to study. An instrument records the electrical activity in
your muscle at rest and as you contract the muscle. This test can help
determine if muscle damage has occurred.
Nerve conduction study.
In a variation of electromyography, two electrodes are taped to your
skin. A small shock is passed through the median nerve to see if
electrical impulses are slowed in the carpal tunnel. These
tests are also useful in checking for other conditions that might mimic
carpal tunnel syndrome, such as a pinched nerve in your neck. Your
doctor may recommend that you see a rheumatologist, neurologist, hand
surgeon or neurosurgeon — depending on whether you have additional signs
or symptoms of other medical disorders or need specialized treatment.
Carpal tunnel syndrome
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