The Anatomy of Carpal Tunnel Syndrome:
Welcome back to our channel! Today, we’re going to talk about the anatomy of Carpal Tunnel Syndrome, a common hand condition that is often characterized by numbness, tingling, burning and pain in the hands. We’ll break down what Carpal Tunnel Syndrome is and how it affects your hands and wrists. As always, this video is informational and not a substitute for evaluation by an appropriate medical professional. Let’s get started!
What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome, or CTS, is a common group of symptoms; like hand numbness, tingling, and burning; which is caused by compression of the median nerve as it passes from the forearm to the hand through a narrow passageway in your wrist called the carpal tunnel. To understand CTS better, let’s take a closer look at the anatomy and what’s going on in your wrist.
Anatomy of the Wrist
The Median Nerve
The median nerve is one of three major nerves that extend to the hand. It travels down the forearm, through the wrist, and branches out to the thumb, index finger, middle finger, and half of the ring finger. The other half of the ring finger and the small finger are given sensation by a different nerve, called the ulnar nerve, which also travels down the forearm, through the wrist, and branches to the small finger and the adjacent half of the ring finger. In carpal tunnel syndrome, the median nerve is getting compressed as it passes through the wrist in an area called the carpal tunnel. This compression or pressure on the nerve is irritating to the nerve.
The median nerve carries both sensory and motor fibers into the hand, both of which can be affected by the pressure on the median nerve in the carpal tunnel. The nerve does not like the pressure and it tells us it is unhappy by giving us numbness, tingling, burning, and pain. Where do these symptoms occur? Well, typically in the area supplied by the median nerve, which as we’ve discussed, includes the thumb, index finger, middle finger, and half of the ring finger. Symptoms can be felt in all of these fingers or in some combination of these fingers, and often can even feel like they are affecting the whole hand. These symptoms are often brought on or made worse with sleep at night or with daytime activities such as driving, writing, typing, doing hair, using your phone or other daily activities. Other symptoms commonly reported include: hand weakness, frequently dropping things, aching, and difficulty with activities requiring hand dexterity or repetitive movements.
The Carpal Tunnel
The pressure on the median nerve in carpal tunnel syndrome occurs where it passes through a passageway in the wrist called the carpal tunnel. This passageway is formed by the bones and the ligaments of the wrist. In this diagram you can see that the median nerve and the flexor tendons to the fingers travel under a ligament called the transverse carpal ligament. A cross sectional view of the wrist at this level shows the nerve and tendons traveling through this opening formed on three sides by the bones in the wrist. The top or roof of the opening is the transverse carpal ligament. The bones and the transverse carpal ligament form the opening, or passageway, through which the nerve and tendons travel to get from the forearm into the wrist. This passageway is the carpal tunnel. So, if you have a hand and a wrist, you likely have a carpal tunnel. However, just because you have a carpal tunnel, does not mean you have carpal tunnel syndrome. Carpal tunnel syndrome is the numbness, tingling, burning, and pain you feel when the median nerve is getting crowded or compressed as it is passing through the carpal tunnel.
It is helpful to understand that all carpal tunnel syndrome is not the same. Some patients have very mild carpal tunnel syndrome, others have very severe carpal tunnel syndrome, and most fall somewhere between mild and severe. It is important to understand the severity of YOUR carpal tunnel syndrome because understanding the severity allows us to make better treatment decisions and to have appropriate expectations about treatment outcomes and success. The severity of YOUR carpal tunnel syndrome and its impact on treatment and outcomes can best be assessed through a full evaluation by a qualified professional. Early evaluation and management generally leads to the best outcomes and helps avoid permanent problems associated with nerve damage in delayed treatment.
Causes of Compression
Patients frequently ask what causes the compression on the median nerve. While there are several potential causes of compression of the median nerve ranging from swelling and inflammation to wrist injuries, arthritis, and even underlying medical conditions like diabetes or thyroid disorders; in many cases the cause is idiopathic, or unknown. Research is ongoing to try to better answer this question.
If you suspect you have CTS, consult a healthcare professional. They will perform a physical examination. In some cases, additional testing like nerve conduction studies (NCS) with or without electromyography (EMG) can assist with confirming the diagnosis.
The good news is that Carpal Tunnel Syndrome is treatable! Depending on the severity, treatment options may include:
· Rest, stretching, and modification of hand activities.
· Wrist splints while sleeping.
· Anti-inflammatory medications
· Corticosteroid injections
· Carpal tunnel release surgery
In summary, Carpal Tunnel Syndrome is a condition that results from the compression of the median nerve within the carpal tunnel of the wrist. Understanding its anatomy, causes, symptoms, and treatment options can help you take better care of your hand and wrist health.
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