Yoram Tangdirussun, MD.

SUNDAY, JANUARY 22TH, 2023

CARPAL TUNNEL SYNDROME

Source: kompas.com
Often we feel tingling in the palms and fingers after doing activities such as riding a bicycle,
working with grasping activities and others. This disorder is known as Carpal Tunnel Syndrome (CTS)
/ Carpal Tunnel Syndrome due to pressure on the median nerve in the wrist area.

SYMPTOM
Symptoms of carpal tunnel syndrome usually start gradually.
1. Tingling or numbness in the wrist & fingers (except the little finger): there is a
sensation like an electric shock in the wrist and fingers, except the little finger.
Sufferers generally make a handshake motion to relieve this sensation.
2. Weakness in gripping power in the fingers: sufferers may experience
weakness & feel weak in the hand so that they can accidentally drop objects.
This can be due to weakness of the muscles surrounding the thumb.
3. Burning feeling in the palms & prickling sensation especially in the thumb,
forefinger and middle finger.
The causes of carpal tunnel syndrome are generally caused by lifestyle, work (office
syndrome) and body conditions that put repeated pressure on the palms of the hands. The most
common causes include; such as typing, moving a computer mouse, or wrist movements that
are performed repeatedly in sports activities such as cycling, lifting weights, conditions such as:
hypothyroidism, obesity, rheumatoid arthritis, and diabetes after pregnancy trauma / accidents.
Medically, this syndrome is caused by pressure on the median nerve which is in the
forearm area through the tunnel at the wrist (carpal tunnel) and continues to the fingers. This
nerve provides sensation to the palm side of the thumb and other fingers (except the little finger).
The median nerve also provides nerve signals to move the muscles around the base of the
thumb (motor function), so anything that compresses or irritates the median nerve in the carpal
tunnel space can cause Carpal Tunnel Syndrome / Carpal Tunnel Syndrome disease.

DIAGNOSIS
1. Tinel's test : the doctor will tap on the median nerve in the wrist to see if
there is a tingling sensation that occurs in the fingers.
2. Wrist flexion test (Phalen test): patient places the elbow on the table and
allows the wrist to fall forward freely. Carpal tunnel syndrome sufferers will
experience numbness and tingling in the fingers within 60 seconds.
3. X-ray: used if there is limited wrist movement or evidence of arthritis, or trauma.
4. Electromyography (EMG) and nerve conduction studies: test the
effectiveness of the median nerve and how well it controls muscle movement.

PREVENTION
There are several ways you can do to minimize the occurrence of carpal tunnel syndrome, including :
rest your hands or reduce activity if repetitive movements are the cause of this syndrome, reduce the
strength in your hand grip, press the buttons gently, use a large pen with a soft grip adapter, take the
time to stretching your hands, such as bending your hands and wrist periodically, but don't force it too
up or too down, maintain your posture, use a mouse with a mousepad wich you feel comfortable at
your wrist hand and your hand.

TREATMENT / TREATMENT
1. Immobilization. The doctor may advise the patient to wear a splint so that the hand
does not move and reduces pressure on the median nerve
2. Treatment with drugs. The doctor may give anti-inflammatory drugs or steroid
injections and painkillers drugs to reduce the swelling / inflammation of the compressed
median nerve.
3. Operation. If other options are nothing else efective, surgery will be the last option by
increasing the size of the carpal tunnel to relieve pressure on the median nerve.