Carpal Tunnel Syndrome
The Median Nerve (Figure 1)
runs
into the hand to supply the sensation for the Thumb, Index Finger
Long Finger and a Good Portion of the Ring Finger. It is also
responsible for the Musculature of the Thumb called the Thenar
Muscles. These muscles (Figure 2)
are also effected by Carpal Tunnel Syndrome in the fact that
weakness can occur. This weakness results in the inability to bring
the thumb into position with the other fingers and eventually
hinders the grasp of the individual sufferer. As well as, The
everyday use of the hand as compared to everyday use before Carpal
Tunnel Syndrome set in.
As time goes on and Carpal Tunnel Syndrome progresses use of the
hand and the thumb becomes more difficult. Tasks that require thumb
or hand strength or minute precise movements get more and more
fatiguing as the progression of Carpal Tunnel Syndrome continues. As
Carpal Tunnel Syndrome advances numbness and pain is a pronounced
result. The pain can radiate up the arm to the shoulder and
sometimes as far as the neck. Additionally numbness usually strikes
in the hands and sometimes the wrist. On a daily occurrence. (See
Figure 3)
Most individuals wake to find that their first three digits on their
hands have a "Pins And Needles" feeling in them. They "Tingle". They
don't have normal feeling or reaction for a slight time period.
Looking at the cross section of the wrist (Figure 4) we see the
Flexor Tendons, In white, With the Median Nerve, represented by the
orange circle, laying underneath the Transverse Carpal Ligament. The
Flexor Tendons allow us to move our hands and digits such as when we
type and grasp something. These tendons are covered by a
slippery material called Tenosynovium. The Tenosynovium allows the
tendons to glide and move against each other as the fingers and hand
moves. The constant repetitive motion involved in the beginning
process of Carpal Tunnel Syndrome causes the tendons to become
irritated and inflamed. This can result in swelling and thickening
of the Tenosynovium. As the tendons swell and thicken they start to
place pressure on the Carpal Tunnel itself. (See Figure 5)
 The
Carpal Tunnel itself cannot increase in size with respect of the
swelling and inflammation of the tendons. The Carpal Tunnel is made
up of bones and ligaments. They are not able to stretch. So as the
swelling increases there is an increase of pressure on the Median
Nerve against the Transverse Carpal Ligament. (The White Sheath In
The Figure 5) Slowly over time, Enough pressure takes it's toll on
the Median Nerve and it can no longer function normally. At that
time the pain and the numbness become pronounced. Carpal Tunnel
Syndrome is then apparent to the individual.
Symptoms
If You Have Any Of These Symptoms You May Be
Suffering From Carpal Tunnel Syndrome:
Pain, Tingling Or Numbness in the thumb, index, middle or ring fingers.
Tingling or numbness of your entire hand.
Pain that shoots from your hands up the arm as far as the shoulder.
A swollen or tightness feeling in your hands or wrists.
Sometimes you may also notice that:
One or more of the above symptoms are worse at night or when you first
get up in the morning.
Your hands or lower arms feel weak in the morning.
You may drop objects more than usual.
You may have trouble pinching or grasping onto objects.
You may have trouble performing detail tasks such as writing or tying
your shoes.
You may have trouble performing tasks that require strength such as
opening a sealed jar or using a screw driver on a tight screw.
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