Medi-Fax Health Information Center

What is carpal tunnel syndrome?

     Carpal tunnel syndrome is the pinching of the median nerve at the wrist. This nerve together with several tendons passes through a tunnel, known as the carpal tunnel, at the wrist. Sometimes the tunnel is too small for its contents, or the contents are too big for the tunnel. Either way the contents may become pinched. The median nerve is the most sensitive of the contents.

Figure 1.

     The symptoms often consist of painful numbness of the hand. The pain is often worse at night. Some sufferers are unable to hold fine objects. Some have weakness and wasting of the hand.

     Many patients are involved with activities that require repetitive movement of the wrist (including typists, staff at checkout counters, carpenters, housewives, workers at poultry processing plants, etc.).

     We perform many tests to rule out conditions such as arthritis, low thyroid, etc., which could cause a disproportion between the tunnel and its contents. The definitive test to assess the degree of pinching of the median nerve is the EMG and Nerve Conduction Study.

     Prevention of this syndrome is by avoiding, if possible, those activities that bring on the symptoms. Some people have found benefit from the use of wrist braces.

• Vitamin B₆ has been used in mild cases
• Treatment of related medical conditions such as hypothyroidism
• Surgery for the more severe cases

     Surgery may be performed using an open or closed method. I, Dr. Chris Ekong, prefer the closed method which consists of a 1cm incision at the front of the wrist along the skin crease. A special instrument is then used to split open the band in front of the tunnel. This method has the advantage of leaving a very small or no scar.

Figure 2.

Figure 3.

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