Frequent questions about Carpal Tunnel Syndrome

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What is carpal tunnel syndrome?

The carpal tunnel is an anatomical space that is found between the palmar surface of the carpal bones of the wrist and the annular or transverse carpal ligament in the dorsal area. The median nerve passes through the interior of the tunnel, as well as the superficial and deep muscle tendons of the fingers, and the large flexor muscle of the thumb.

Is carpal tunnel syndrome more common in women or men?

The prevalence in the European population is 1-7%, with a 5.3% of appearance in women and 2.1% in men. it affects women of a mean age of 50 years.

Do I have a carpal tunnel syndrome if my hand goes numb?

Not necessarily, since the numbness and tingling sensation in the hand may be due to other causes different to compression of the median nerve of the wrist.

What symptoms are present in the hand in order to suspect a carpal tunnel syndrome?

Pins and needles and tingling of the hand that may cause discomfort during the night that improves on shaking the hand. Daytime pain in the hand that increases with activity. Muscle weakness of the thumb that manifests with difficulty in gripping and pinching.

What is the mechanism that leads to a carpal tunnel syndrome?

In carpal tunnel syndrome, the mechanism by which the nerve is damaged is due to the increase in the pressure within the tunnel due to intrinsic and extrinsic causes that trigger discomfort in the wrist and the hand. This increase in pressure produces a space conflict, with inflammation of the tendon sheaths of the flexor tendons within the tunnel and ischaemia of the median nerve.

I have rheumatoid arthritis and have started to have pins and needles and tingling of the hand. What can be the cause?

It is possible that the cause may be a carpal tunnel syndrome as a result of a space conflict produced by the arthritis inside the carpal tunnel.

What is the Tinel sign?

The Tinel sign consists of manual percussion of the carpal tunnel in order to detect if there is inflammation of a nerve. In the case of having it, the patient feels pins and needles and cramp.

What is the Phallen sign?

The Phallen sign consists of maintaining the wrist in forced flexion for 1 minute. If there is compression of the median nerve in the carpal tunnel, tingling usually appears in the palm of the hand and in the fingers that depend on the median nerve, although the discomforts are normally produced in the tips of the fingers.

Due to my work activity I make many repetitive flexion and extension wrist movements. Do I have more risk of suffering from carpal tunnel syndrome?

This type of movement can lead to an increase in pressure within the carpal tunnel and damage the median nerve.

What are the measures that I have to adopt in my work in order to prevent the appearance of a carpal tunnel syndrome?

Avoid repetitive movements of the wrist that are forced. If these are unavoidable, try to maintain the wrist in slight extension when the hands are making movements. Use wrist supports or special keyboards when using the computer.

What treatments can improve the discomforts of carpal tunnel syndrome?

Conservative treatment of the carpal tunnel is bases on adopting ergonomic measures in those manual activities that may provoke it, use splints to reduce the pressure in the carpal tunnel, rehabilitation treatment and local corticosteroid injections with or without local anaesthetic.

If I have carpal tunnel syndrome, when should I use a splint?

The use of a splint is recommended, especially, during the night in order to maintain the wrist in a neutral position, although it can also be used all day depending on the pain and discomfort of the patient.

Can the corticosteroid injections be given continuously to alleviate the discomfort in the carpal tunnel?

No. A maximum of 3 injections are recommended, with an interval of 2-3 months between them.

If I take multivitamins, can I reduce the discomforts of the carpal tunnel syndrome?

There is not sufficient scientific evidence that supports pharmacological treatment using vitamins being a treatment of choice for carpal tunnel syndrome.

How can rehabilitation treatment improve the symptoms of carpal tunnel syndrome?

Rehabilitation treatment based on combined therapies using the application of analgesic electrotherapy and exercises, with muscle and tendon stretching and strengthening exercises at wrist level, can alleviate the pain and improve mobility of the wrist.

Substantiated information by:

Joaquim Forés Viñeta
Miriam Morató Dalmau
Núria Millán Villanueva
Raquel Vilarrasa Sauquet

Published: 17 July 2018
Updated: 17 July 2018

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