Carpal Tunnel Syndrome (CTS) is a condition caused by compression of the
median nerve as it travels through the carpal tunnel in the wrist. This compression leads to pain, numbness, and tingling in the hand and arm. The carpal tunnel is a narrow passageway located on the palm side of the wrist that houses not only the median nerve but also tendons that help move the fingers.
Common symptoms of CTS include:
Numbness or tingling in the thumb, index, middle, and part of the ring fingers.
Pain in the wrist or hand that may extend to the forearm.
Weakness in the hand and a tendency to drop objects.
Occasional shock-like sensations that radiate to the thumb and fingers.
Symptoms often worsen at night, which can disrupt sleep.
CTS is often caused by repetitive motions or activities that put stress on the wrist. Some common causes and
risk factors include:
Repetitive hand movements, especially those that involve flexing the wrist.
Conditions such as diabetes, rheumatoid arthritis, and thyroid dysfunction.
Pregnancy, due to fluid retention that can increase pressure on the median nerve.
Heredity, as some people may have smaller carpal tunnels which predispose them to CTS.
Workplace factors involving the use of vibrating tools or assembly line work.
Diagnosis typically involves a medical history review, physical examination, and specific tests such as:
Phalen's Test: This involves flexing the wrist and observing if symptoms are reproduced.
Tinel's Sign: Tapping over the median nerve to see if it causes tingling in the fingers.
Nerve conduction studies and electromyography (EMG) to assess the electrical activity of the median nerve and muscles.
Treatment for CTS may range from conservative methods to surgical interventions:
Wrist Splints: These help keep the wrist in a neutral position, especially at night.
Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
Activity modification to avoid repetitive wrist movements.
Corticosteroid injections to reduce inflammation and swelling.
In severe cases, surgical options such as carpal tunnel release may be considered to relieve pressure on the median nerve.
Nurses play a crucial role in the management and education of patients with CTS. Responsibilities include:
Educating patients on proper hand and wrist ergonomics to prevent worsening of symptoms.
Assisting with the application and adjustment of wrist splints.
Administering medications and monitoring for side effects.
Providing post-operative care and education if surgery is required.
Encouraging adherence to treatment plans and follow-up appointments.
Preventive measures are essential to reduce the risk of developing CTS. These include:
Maintaining proper wrist alignment and ergonomics during activities.
Taking frequent breaks from repetitive tasks to stretch and rest the hands and wrists.
Using ergonomic tools and workstations designed to reduce wrist strain.
Strengthening and stretching exercises for the hands and wrists.
