Carpal tunnel syndrome is a nerve compression disorder. It can occur due to repetitive motion at work or at home, or may happen secondary to another condition such as arthritis. Whatever the cause, this condition can be painful and can limit function if not treated early.

Carpal tunnel syndrome occurs when the median nerve of the arm is compressed, or pinched, at the wrist. The median nerve runs from the cervical spine, the lower neck, down the arm to the tips of the thumb and the first three fingers. It supplies the feeling to these fingers and the palm of the hand, as well as portions of the forearm. Just prior to branching to the palm and fingers, the median nerve passes through the carpal tunnel, which is made up of the carpal bones of the wrist on three sides and the transverse carpal ligament on the forth side. The tendons from the flexor muscles in the forearm pass through this tunnel along with the median nerve.

When this condition occurs, swelling causes the carpal tunnel to narrow, creating less space in the tunnel for the tendons and median nerve to pass through. If the swelling becomes pronounced, the median nerve becomes compressed. This leads to pain, numbness and tingling in the thumb, index, middle and part of the ring fingers. If the symptoms are severe or occur over a period of time, weakness in the hand may also occur.

There are many factors that can cause carpal tunnel syndrome. The most well known and well debated is repetitive motion, especially as applied to work situations. Working a repetitive motion job where the biomechanics of the job are poorly set up can place a person at an increased risk for carpal tunnel syndrome. An example of this is typing at a keyboard for 8 hours a day at a desk where the keyboard is placed at shoulder height, causing the person to type with his or her wrists bent. Assembly line jobs that do not use ergonomic tools are also at risk for this syndrome.

Prior injury to the wrist also places a person at risk for this condition. A prior fracture or ligament tears at the wrist may have resulted in scar tissue in the carpal tunnel. This will naturally narrow the area and will place a person at increased risk for developing the syndrome.

People with arthritis are also at an increased risk for developing carpal tunnel syndrome. As the swelling of arthritis settles into the carpal tunnel, it thickens the fluids, stiffens the tissues and narrows the tunnel, causing compression on the median nerve.

Catching carpal tunnel syndrome early and managing it conservatively is the most effective way to treat this condition. Keeping the wrists in straight, neutral positions will reduce the pressure on the median nerve when completing daily activities. Wrist support braces will help maintain this position, especially at night when people have a tendency to curl their arms while sleeping. Using ergonomic tools and making changes to work stations to make sure the wrists are in straight, neutral positions will also assist in taking the strain off of the carpal tunnel area. Frequent rest breaks and ice or cold packs will help to keep swelling down.

If this condition becomes advanced, surgery to release the transverse carpal ligament is an option. This procedure has become much less invasive in recent years and recovery takes much less time. The wrist structure is not compromised by this procedure, although hand strength may be slightly reduced. Proper precautions, including following the same conservative management techniques while recovering from surgery, are important for the procedure to be effective. If not, scar tissue may form and the same type of compression on the median nerve may occur.

Clearly early identification and treatment of this condition can limit its effects and allow a person to maintain hand function for many years.