Carpal Tunnel Syndrome Cary NC

Carpal tunnel syndrome has gained a lot of attention over the past decade. Some say it is a sign of our technology-based society because so many patients complaining of the syndrome found that it resulted from constant computer use. However, this syndrome can result from many exercises in which the hand or wrist is over-used. Understanding the condition, how it progresses, and what the healing process is like will help in avoiding the condition or in assisting with the treatment process.

The carpal tunnel is a passageway through the wrist that protects the nerves and tendons that extend into the hand. The median nerve, a nerve is both motor and sensory, within the carpal tunnel is very close to nine tendons. When the tissues which make up the tunnel become inflamed or swollen, or if one or more of the tendons becomes injured, the median nerve is compressed. This compression of the median nerve within the carpal tunnel produces numbness in the thumb and the second, third, and radial half of the fourth fingers. A physical examination of the hands, arms, shoulders, and neck can help determine if the patient's complaints are related to daily activities or to an underlying disorder, and can rule out other painful conditions that mimic carpal tunnel syndrome. The wrist is examined for tenderness, swelling, warmth, and discoloration. Each finger should be tested for sensation, and the muscles at the base of the hand should be examined for strength and signs of atrophy. Routine laboratory tests and X-rays can reveal diabetes, arthritis, and fractures.

A study published in the journal, Neurology, assessed trends in the incidence of carpal tunnel syndrome between 1981 and 2005 among residents of Olmstead County, Minnesota. During that time period, a total of 10,069 people were diagnosed with carpal tunnel syndrome. The incidence of carpal tunnel syndrome was 376 per 100,000 people per year. It was also found that the incidence rate among women was even higher at 491 per 100,000 people. The results revealed that the rate of diagnosis nearly doubled over the course of the study period, from 258 per 100,000 people between 1981-1985 increased to 424 per 100,000 people between 2000-2005. The researchers believe that the major increase in carpal tunnel syndrome which began in the 1980s would be difficult to attribute solely to changes in medical or physical risk factors and that it is likely in part due to increased public awareness of the condition. In the later years of the study, more elderly people were being diagnosed with carpal tunnel and their cases were usually more severe and were more likely to require surgery. It is thought that if the trend in elderly people continues there will be a greater number of operations and associated expenditures for carpal tunnel syndrome as our population ages.¹

¹ Gelfman R, Melton LJ, Yawn BP, et al. Long-term trends in carpal tunnel syndrome. Neurology. Jan2009;72:33-41