Carpal Tunnel Syndrome

This syndrome forms as the result of compression of the median nerve as it passes through the carpal tunnel (wrist tunnel), formed by the carpal bones and the flexor tendons of the fingers and wrist. The most common causes of this are thickening and swelling of the tendon sheaths or the irregularity or enlargement of the carpal bones due to osteoarthritis. Alternatively, chronic conditions such as amyloidosis, diabetes mellitus and rheumatoid arthritis as well as hormonal changes due to pregnancy or menopause can narrow the diameter of the carpal tunnel, compressing the median nerve. Finally, fractures to the wrist can also cause damage to the median nerve, bringing on the onset of this condition. Initial symptoms include nocturnal disturbances as a result of tingling/ numb sensations in the hand and fingers.  Patients frequently discuss difficulties in performing delicate tasks like tying shoelaces or buttoning up thier shirts. After some time, these feelings of tingling evolve into feelings of pain, especially during movement, that persists throughout the day. Given the fact that motor fibers are also often involved in this condition, the nerve supply to the thumb muscles can be affected, leading to weakness and wasting. Diagnosis of this disorder is based on specific clinical tests backed by electromyography (EMG) test to confirm the extent of nerve degeneration. Depending on the patient’s clinical history, other tests such as blood tests, X-rays and CT scans may be useful in cases of secondary forms of this disorder. Prognosis here generally leads to a total absence of any sensory disturbances after a few months. Rehabilitation using splints and physical treatments to address the muscular imbalances, especially those in the wrist and forearm, is key for the restoration of fine motor control. In more advanced cases where motor components are affected, a surgical procedure known as ‘carpal tunnel release’ may be required to prevent irreversible damage to the nerve and the muscle it supplies.

While neck pain is common, it is not normal and should receive professional medical care to determine the cause. Dr. Daniel J. Saenz at MVMT Matters in Sacramento, California, is experienced in accurately diagnosing and treating chronic and debilitating neck pain. Call today to schedule your appointment.