What is carpal tunnel syndrome? Symptoms and causes

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What you need to know about carpal tunnel syndrome

Carpal tunnel syndrome has become a more common health problem today, especially with the increased use of computers and repetitive hand movements. This condition, which can present with symptoms such as numbness, tingling, and loss of strength in the hand, can significantly affect daily life if not recognized early.

So, what is carpal tunnel syndrome, and why does it occur? In this article, we discuss the most frequently asked topics, from symptoms and causes of the disease to treatment options and the surgical process.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition that occurs as a result of compression of the median nerve passing through a narrow canal in the wrist. This canal is called the carpal tunnel, and the nerve passing through it controls the sensation and movement of part of the hand, especially the thumb, index finger, and middle finger. When the pressure inside the tunnel increases, the nerve cannot function properly, and various complaints arise.

This condition usually develops slowly and may initially present with mild symptoms. On the other hand, symptoms such as increased numbness at night and waking up shaking the hand may appear in later stages.

Carpal tunnel syndrome can affect frequently used hand movements in daily life. Over time, it may lead to problems such as difficulty holding small objects, dropping items, or decreased fine motor skills. Therefore, early recognition and treatment are important. Consulting a specialist when symptoms are noticed is the most appropriate approach to prevent progression of the disease.

What causes carpal tunnel syndrome?

As mentioned earlier, carpal tunnel syndrome occurs as a result of compression of the median nerve within the carpal tunnel in the wrist. The pressure, friction, and compression in this area usually develop not due to a single cause but as a result of multiple factors coming together. Swelling or thickening of the tissues within the tunnel or further narrowing of the already limited space can affect the nerve.

One of the most common causes is repetitive wrist movements. Long-term computer use, working with a keyboard and mouse, handicrafts, or occupations requiring constant wrist use can create pressure in this area over time.

The main causes of carpal tunnel syndrome can be listed as follows:

• Repetitive hand and wrist movements: Constant repetition of the same motion can increase pressure on the nerve.
• Edema and fluid retention in the wrist: Common especially during pregnancy or hormonal changes.
• Rheumatic diseases: Can narrow the tunnel by causing inflammation and swelling around the joints.
• Diabetes and thyroid diseases: May affect nerve structure and increase sensitivity.
• Obesity: Can contribute to increased pressure in the wrist area.
• Trauma: Structural changes after wrist fractures or sprains may cause nerve compression.

In addition, some individuals may have a naturally narrower carpal tunnel, which increases the risk. It is also known to be more common in women, especially during middle age, due to hormonal effects.

Carpal tunnel syndrome usually develops slowly and may initially present with mild symptoms. However, as long as the underlying factors persist, complaints may increase over time. Therefore, early recognition and taking necessary precautions are important.

What are the symptoms of carpal tunnel syndrome?

Symptoms of carpal tunnel syndrome usually progress gradually. What starts as mild complaints can eventually reach a level that affects daily life. Symptoms are mostly felt in the hand, especially in the thumb, index finger, and middle finger. The most common symptoms can be listed as follows:

• Numbness and tingling: Especially felt in the thumb, index finger, and middle finger. More common at night.
• Numbness that wakes you up at night: One of the most characteristic signs of carpal tunnel syndrome.
• Pain: May start at the wrist and spread to the hand and sometimes to the arm.
• Loss of strength: Difficulty holding objects or frequently dropping them.
• Sensitivity and burning sensation: An uncomfortable feeling may occur at the fingertips.

In advanced cases, symptoms become more pronounced. A decrease in fine motor skills is particularly noticeable. Tasks such as buttoning clothes, writing, or grasping small objects may become difficult. If left untreated for a long time, weakness in the thumb muscles may develop.

Symptoms often worsen during periods of intensive hand use or when staying in the same position for a long time. Complaints commonly become more noticeable after computer use.

Can carpal tunnel syndrome occur during pregnancy?

Carpal tunnel syndrome can occur during pregnancy and is quite common. The main reason for this is hormonal changes and fluid retention (edema) in the body during pregnancy. This condition increases pressure within the carpal tunnel in the wrist, leading to compression of the median nerve. Symptoms may become more pronounced, especially in the second and third trimesters. The most common complaints are as follows:

• Numbness and tingling in the hand
• Loss of sensation in the fingers
• Pain that increases at night
• Stiffness and weakness in the hand in the morning

These symptoms are usually seen in both hands and may become more uncomfortable at night. This is due to changes in fluid distribution at night and increased pressure in the wrist area. Carpal tunnel syndrome that develops during pregnancy often resolves on its own after childbirth. Therefore, treatment is usually aimed at relieving symptoms.

To manage symptoms, measures such as resting the wrist, avoiding staying in the same position for long periods, and using a wrist splint recommended by a doctor may provide relief.

However, if the complaints are very severe, significantly affect daily life, or persist after childbirth, it is necessary to consult a specialist.

How is carpal tunnel syndrome treated?

The treatment of carpal tunnel syndrome is planned depending on the severity of the disease and how advanced the symptoms are. The main goal of treatment is to reduce pressure on the median nerve and control the symptoms.

This process usually progresses step by step, from simple treatment measures to more advanced methods. In mild and early-stage cases, non-surgical methods are often sufficient. The treatments applied at this stage can be listed as follows:

• Resting the wrist: Avoiding repetitive movements reduces pressure on the nerve.
• Use of a wrist splint: Especially splints used at night can help reduce nerve compression by keeping the wrist stable.
• Medication: Pain relievers or anti-inflammatory drugs recommended by a doctor can relieve symptoms.
• Physical therapy and exercises: Nerve gliding exercises and muscle strengthening can be beneficial.

In moderate cases, corticosteroid injections may be added to the above methods. This treatment can temporarily relieve pressure on the nerve by reducing inflammation and swelling within the tunnel.

In advanced and long-standing cases, surgical intervention may be considered. The aim of the surgery is to permanently eliminate pressure on the nerve by releasing the connective tissue forming the carpal tunnel. It is usually a short procedure with successful outcomes.

Early diagnosis is very important during the treatment process. If intervention is made before symptoms progress, the condition can be controlled without the need for surgery.

How is carpal tunnel syndrome surgery performed?

Carpal tunnel syndrome surgery is a surgical procedure performed to relieve pressure on the median nerve in the wrist. The aim is to widen the tunnel and relieve the nerve by cutting the connective tissue forming the carpal tunnel.

The surgery is usually performed under local anesthesia, and the patient may remain awake during the procedure. It is generally a short operation and does not require a long hospital stay. The procedure can be performed using two different techniques:

• Open surgery: A small incision is made on the inner side of the wrist. The surgeon cuts the connective tissue forming the carpal tunnel to relieve pressure on the nerve. It is one of the most commonly used and reliable methods.
• Endoscopic (closed) method: A technique performed with smaller incisions using a camera. Although the recovery time is usually faster, it may not be suitable for every patient.

The success rate of the surgery is generally high. However, if the nerve has been under pressure for a long time, it may take time for some symptoms to fully resolve. The decision for surgery is made based on the severity of the patient’s complaints and their response to other treatments. Therefore, a detailed evaluation by an orthopedic or hand surgery specialist is important before surgery.

Do pain symptoms continue after carpal tunnel syndrome surgery?

Pain usually does not persist after carpal tunnel syndrome surgery. However, it is normal to experience pain in the first days and during the early recovery period. Since tissues are affected during the surgical procedure, moderate pain, tenderness, and a feeling of tightness may occur in the surgical area for a few days to a few weeks.

After surgery, the following conditions may be observed:

• Pain and tenderness in the surgical area
• Discomfort that increases with movement
• Aching related to the healing process

However, nerve-related symptoms such as numbness and tingling caused by carpal tunnel syndrome usually decrease over time after surgery. If the nerve has been under pressure for a long time, it may take weeks or even months for these symptoms to completely disappear. In general, post-operative pain is temporary and manageable in most patients.

Frequently Asked Questions

Can carpal tunnel syndrome heal without surgery?

In some cases, carpal tunnel syndrome can be managed without surgery. However, this depends on the stage of the disease and the severity of the pressure on the nerve. Especially in early and mild cases, it is possible to reduce symptoms and stop progression without surgical intervention.

However, if symptoms are advanced, there is significant loss of strength in the hand, or the nerve has been under pressure for a long time, non-surgical methods may not be sufficient. In such cases, surgical treatment may be considered.

Does carpal tunnel syndrome cause numbness?

Yes, carpal tunnel syndrome most commonly presents with numbness and tingling in the hand. This occurs as a result of compression of the median nerve within the carpal tunnel in the wrist.

Numbness is usually felt in the thumb, index finger, middle finger, and part of the ring finger. It is an early and important symptom of carpal tunnel syndrome. Therefore, if there is frequent or progressively increasing numbness, it is important to consult a specialist before nerve damage develops.

What happens if carpal tunnel syndrome progresses?

If carpal tunnel syndrome progresses without treatment, the pressure on the median nerve in the wrist increases, which can lead to more serious problems, including permanent nerve damage. Symptoms that are initially mild become more frequent, more severe, and continuous over time. At this stage, since nerve damage may become permanent, it may not always be possible to fully resolve all symptoms even with treatment. Therefore, early intervention is very important.

Do carpal tunnel syndrome exercises work?

Exercises for carpal tunnel syndrome can be beneficial, especially in early and mild cases. These exercises help reduce pressure on the median nerve, increase the flexibility of the tissues around the wrist, and contribute to relieving symptoms. However, they may not always be sufficient on their own and are usually applied together with other treatment methods.

On the other hand, in advanced carpal tunnel syndrome, especially if nerve damage has developed, exercises alone may not be sufficient. In such cases, different treatment options may be considered. Since performing exercises incorrectly may worsen symptoms, starting them with the recommendation of a physiotherapist or doctor is the safest approach.

Which medical specialty treats carpal tunnel syndrome?

Carpal tunnel syndrome is generally within the field of orthopedics and traumatology, neurology, and, in some cases, neurosurgery. The evaluation and treatment plan of the disease can be managed by these specialties depending on the severity of the symptoms and the patient’s condition. Initially, it is appropriate to consult an orthopedic or neurology specialist. If necessary, referral between relevant specialties is made.