Have you ever experienced sitting at your desk, typing on your keyboard and then suddenly stopping as you feel your fingers going numb, with pain shooting up from your wrist? If this goes on for weeks, you may be suffering from carpal tunnel syndrome.
Carpal tunnel syndrome (CTS) is a group of symptoms that result from the compression of a major nerve in the wrist area, says Dr. Ida S. Tacata of the Makati Medical Center’s Department of Orthopedic Surgery. This major nerve is called the median nerve, which provides feeling and movement to parts of the hand. The area in the wrist where the nerve enters is called the carpal tunnel. “We say ‘group of symptoms’ because it’s not found consistently in all patients, but the most common and prominent is numbness of the thumb and the index and middle fingers,” the doctor explains.
Different people with CTS will have different ways of expressing the sensation they are feeling. “Some patients say they’re feeling pins and needles, or that the hand feels heavy,” she says. “I had a patient who said he could feel his fingertips being burned, and one who said his fingers felt covered in soap suds.” All of these refer to the sensory function of the hand, which is affected because of the compression of the median nerve, says Dr. Tacata.
People who perform repetitive and forceful motions of the hand and wrist are at risk of CTS. Another contributory factor is age and gender, with the condition more common among women and people aged 40 to 60. “It has something to do with hormonal imbalance. Pregnant women and menopausal women have the tendency to retain water,” says the doctor, adding that fluid retention can increase the pressure on the carpal tunnel and lead to CTS.
People with existing medical conditions, such as diabetes and thyroid problems, should also watch out for CTS symptoms. “If you are diabetic, your tendons have the tendency to swell up. If you have a thyroid problem, you also retain fluids, and one of the areas where fluid can build up is in the wrist area,” Dr. Tacata says.
CTS can be diagnosed through a clinical diagnosis, with the doctor getting the patient’s medical history and symptoms. In some cases, the doctor can require additional tests, such as electromyography (EMG) and nerve conduction velocity (NCV, or simply CV). Electromyography checks the health of the hand’s muscles and nerves, while the NCV tests how fast electrical signals travel through the nerves.
If CTS is diagnosed early, the patient will have time to try conservative or non-surgical treatment which is aimed at reducing pressure around the nerve. This involves splinting and ergonomic aids like a special mouse pads or activity restriction and lifestyle change to avoid force that can worsen the condition.
When the nerve compression is severe, a patient may need to undergo surgery. A standard surgery lasts 30 minutes, but a patient has to wait up to four weeks before resuming simple tasks like typing, and it will take up to eight weeks before one is allowed to do more labor-intensive activities.
When left untreated, CTS can lead to nerve damage. “For office workers, it is very important that you have proper positioning of the body in your workstation when you type,” she says. “Keep your wrists level – not bent upwards or downwards – to avoid injury.” Dr. Tacata says the simplest rule is: if you feel pain or numbness, stop and rest. If these sensations remain, see a doctor. “Early diagnosis is key,” she says.