Running across the palm of the hand into the wrist and forearm lies the median nerve. The nerve provides sensation for your inner palm, and is protected by the hard tunnel made of bone and tendons known as the carpal tunnel.
When the tendons making up the carpal tunnel become aggravated from overuse, they can swell, which causes pain. Eventually, that pain can worsen to include numbness and severe pain from the palm running up the arm, as the median nerve is pressured from the surrounding tissue.
In the beginning, the experience is slight, and increases to sensations of burning, pins or a numb itch from the palm out to the fingers, with a focus on the center of the hand, inner thumb, index and nearby fingers – excluding the littlest, which isn’t connected by the median nerve. All of this will worsen when the wrists have been tight during the night, until the feelings persist during the day.
The ability to hold objects and form a fist will also be jeopardized as the inflammation and nerve damage intensifies, until, if untreated, the muscles in the lower part of the thumb will atrophy.
There are many possible causes, but for being so evident and common, there is still mystery that surrounds some cases when no cause can be identified. In most instances, however, the carpal tunnel may be inherently narrow. In other cases, work stress or acute injury can lead to a compressed nerve. Yet there is little evidence that verifies repeated actions cause the amount of stress required to create carpal tunnel syndrome. It’s a question of cause and effect – and it’s difficult to pin the effect of carpal tunnel syndrome on a specific action.
Because there can be multiple causes for carpal tunnel syndrome, the base cause should be treated at the outset. These may include arthritis or diabetes, or the daily use of the hand and wrist.
To curtail any use that is aggravating the condition, the hand and wrist needs to be immobilized to put it to rest for two or more weeks. Swelling from the inflamed soft tissue can be reduced using cold packs.
After the pain and swelling have subsided, then exercises targeting the carpal tunnel can begin, usually overseen by a physical therapist.
These could include yoga, which has been proven to help strengthen the hand and wrist, which is the goal of the active part of any therapy for carpal tunnel syndrome. In addition, chiropractic therapy can benefit people trying to curtail their symptoms, as it realigns body structures that may have fallen into disrepair, and in the process open up the patient to increased nerve receptivity and self healing.
Surgery, while the last resort, is also incredibly common. It becomes an option after half a year of unrelieved symptoms despite attempting other therapies. The surgeon will cut the ligament that stretches over the median nerve, which will open the chamber in which it rests and give more room.
There are two varieties of surgery – open release and endoscopic. The first is traditional surgery under local anesthetic. The second is less invasive as the surgeon uses a smaller incision to insert a camera and cuts the carpal ligament without breaking the outer skin.