Carpal Tunnel Syndrome: Diagnosis and Treatment

Carpal tunnel syndrome is a neurological disease affecting the wrist zone. The carpal tunnel’s median nerve accounts for normal hand movements. Its nature is fully connected with extrinsic factors such as trauma, monotonous work, tumors, and endocrine profile for females. The listed triggers heavily influence the nerve system functionality. In particular, the vulnerable nerves are located in narrow areas like wrists. In this case, the carpal tunnel shares the pressure impulses and provokes some unpleasant, painful reactions.

The symptoms detect the two conditions that are often misdiagnosed as carpal tunnel syndrome. Hence, the inexperienced neurologists and lack of clinic picture tests could implicate this ailment with wrist tendonitis or arthritis-like syndromes closely resembling carpal tunnel disturbance. 

Anyway, the severe stages of this disorder could have dangerous consequences in the form of surgical interventions. At the same time, minor cases quickly get along with therapy recommendations and medicine prescriptions. 

However, the fundamental point in the treatment strategy of the carpal tunnel disorder is to lead a healthy lifestyle, make temporary relaxing breaks, and follow a vitamin-rich diet. Hence, a special daily ration should include veggies and fruit containing vitamins B, magnesium, selenium, calcium, and a range of helpful minerals.

Carpal Tunnel Syndrome Physical Examination

Early diagnosis is essential to avoid permanent damage to the nerve fibers. A physical examination of the hands, shoulders, and neck can help determine whether the perceived symptoms are related to daily activity or illness and rule out other painful conditions that may mimic carpal tunnel syndrome. Diagnosis is simple and reliable if nocturnal numbness, numbness of the first three fingers of the hand is reported, and a difference in the pad’s sensitivity of the 4th finger. Another decisive sign, if the motor part is involved, is muscle atrophy of the outer part of the thenar eminence, together with muscle weakness in the grip of the 1-2nd finger.

There are also outpatient median nerve problems that your doctor can perform to mimic the symptoms of carpal tunnel syndrome.

• Tinel’s sign. Pain can be induced or reproduced in the median nerve distribution by wrist percussion to confirm the diagnosis of carpal tunnel syndrome. A reflex hammer is commonly used, and an electric shock is triggered at the entrance to the wrist canal.
• Phalen’s sign. The appearance of paresthesia in the fingers due to the maximum flexion of the wrist and keeping it in this position for at least one minute. This is done when the patient is asked to keep the palms unfolded for 30 seconds, keeping the elbows flexed and the forearms horizontal. This puts pressure on the median nerve of the carpal tunnel. The test is considered positive if paresthesias are radiating at the level of the first three fingers of the hand.
• Phalen’s reverse sign. It is performed when the patient is asked to hold the back of the hand with the face for 30 seconds, keeping the elbows flexed and the forearms horizontal. This puts pressure on the median nerve of the carpal tunnel. The test is considered positive if paresthesias are radiating at the level of the first three fingers of the hand.

The range of sensitivity of Tinel’s trait is from 25 to 60%; the specificity is from 67 to 87%. The Phalen test has a sensitivity and specificity range of 40 to 80%. 

Medical Tests and Diagnostical Procedures of Median Nerve Compression

However, two non-invasive and painless tests are performed to confirm the diagnosis and establish the severity of the disease:

• Electroneurography. That is, the study of the response of the median nerve to electrical stimuli, confirms the diagnosis. 

• Electromyography. That is, the study of the activity of the muscles innervated by the median nerve, establishes the severity of the disease and makes it possible for the differential diagnosis between various neuropathies. In the first case, electrodes are placed on the arm and wrist, and the nerve response, such as speed, latency, and amplitude, is measured with small electric shocks. In the second, a needle is inserted into the muscles to study their activity, making it possible to establish the severity of the syndrome and exclude other pathologies.

Ultrasound and MRI can show the anatomy of the wrist, but these data are insufficient to diagnose carpal tunnel syndrome.

How to Treat Carpal Tunnel 

The national clinical investigations consider carpal tunnel-related syndrome to be a nerve pressure ailment or a tunnel neuropathy. This damage of peripheral nerves is provoked by pressure-stimulated or traumatic injuries in the anatomical narrowing. A primary factor for tunnel neuropathy is the narrow pathway through which nerves undergo. In such a way, the unique anatomical structure of wrists and their flexible movements make them vulnerable to cold and tension impacts.

The pain feelings have an extended, explicit, and unbearable nature and could not be eliminated without any actions or agents. If you neglect the wrist abnormalities or think the pain will disappear quickly, you are grossly mistaken.

This insidious disease provokes plenty of accessory neurological disorders. The treatment process of the carpal-tunnel disturbance depends on the severity of the disease and can last for an extended period.

The modern medical treating methods should include the patient’s overall health history and refer to the somewhat effective ways to achieve the positive deliverables. In this case, the patient is advised to apply various non-surgery methods and tools. However, patients with arthritis and diabetes need the particular treatment for the carpal-tunnel-related symptoms, which are removed by surgical intervention. 

To make clear the differences between two common treatment strategies of the various states of carpal tunnel syndrome, you may investigate the table below.

Anyway, everyone should realize that they could face carpal tunnel syndrome at any moment. So, the preventive measures would be helpful to minimize the risk of this syndrome occurring.

• Massage. Simple massaging actions could reduce the pressure prescriptions and resume the normal functional abilities of the hand elements. Moreover, the massage has heating effects on the hands and stimulates the work of median nerve ties.
• Yoga. This is a complex mix of well-grouped exercises which help to enhance the health and the integral functions of all organs, tissues, and nerve ties.
• Relaxation breaks and warm natural clothing stuff. The ingenious is always simple. Let your hands have minor periodical breaks and use the gloves for the hard, monotonous tasks and keep them from cold weather effects, and you crucially decrease the risks of carpal-tunnel-related syndrome.

Alternative Treatment for Carpal Tunnel Syndrome 

You can relieve the symptoms of tunnel syndrome without medication and surgery. This requires:

1. Reduce the stress on the hands and wrists, exclude activities that worsen the condition.
2. Fix the arm with a splint, orthosis, or an elastic bandage to restrict movement.
3. Remove swelling with ice, limit fluid and salt intake.
4. Perform arm gymnastics aimed at stretching the joints. We recommend exercising under the supervision of a physiotherapist.

If there is no improvement, then you should not delay seeking medical attention.

Carpal tunnel syndrome is not life-threatening; it is a slowly ongoing pathological process. The disease has a favorable prognosis for recovery, but some people are in no hurry to visit a doctor due to the neglect of their health. Over time, this leads to decreased motor activity, muscle strength, and fine motor impairment. If left untreated, irreversible processes will begin, the median nerve will atrophy. This will lead to the loss of the functionality of the brush, which will no longer be possible to return.

FAQs

• Who suffers from carpal tunnel syndrome?

The dangerous and severe disease affects females primarily. Women are more vulnerable to such neurological disorders because they frequently have work that involves monotonous tasks and suffers from hormonal imbalances due to pregnancy or menopause changes. In these cases, each woman who feels the painful perceptions in the wrists should immediately apply to the neurologist’s consultation to prevent the severe ailments which require the surgeon’s interventions.

• What is carpal tunnel syndrome caused by?

This syndrome is caused by various internal and external factors varying from hormonal imbalances to accidental traumas. So, nobody could be assured to avoid such syndrome; however, everyone should know the step-by-step actions about how to treat carpal tunnel.

• Who is most likely to get carpal tunnel syndrome?

Women have a higher probability of gaining this syndrome than men. In this case, an annual medical examination should occur with a neurologist consultation about any pain in the wrist area.

• Which muscles are affected by carpal tunnel syndrome?

Muscles are less vulnerable in the case of carpal tunnel syndrome symptoms. The essential object of the painful effects is a median nerve located in the carpal tunnel. So, the adverse reactions in your wrists should give you a clue to apply for the proper neurological aid.