What Causes Carpal Tunnel Syndrome?

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome constitutes one of the most common nerve-related entrapment injuries, implying the conditions where the peripheral nerves remain squeezed or pressed for long durations (1). These conditions usually occur due to the excessive use of video games/mouse/game controllers. People whose profession requires them to work on a laptop/computer for an extended duration also report carpal tunnel syndrome frequently.

Prevalence

The American College of Rheumatology notes that carpal tunnel syndrome impacts approximately 4-10 million adults in the United States (2). Age and sex (female) are the common risk factors associated with the onset of carpal tunnel syndrome, among other factors. Additionally, people with diabetes and other metabolic disorders are also at a higher risk.

Causes

Carpal tunnel, a narrow passageway that ends at the base of the hand, houses the median nerve, various tendons, and blood vessels pass through this narrow opening. The tendons get agitated due to long working hours as well as a bad posture, which puts immense pressure on the median nerve. As a result, the tendons swell, narrowing the carpal tunnel, squeezing the median nerve, and ultimately causing pain, tingling sensation, numbness, shooting electric shocks, weakness in the fingers or palm. These sensations are collectively termed “Carpal Tunnel Syndrome.”

The concept becomes clearer if you envision the continuous clicking movements associated with the use of a mouse.

Some other causes include:

  • Overactive pituitary gland
  • Underactive thyroid gland
  • Fracture/sprain
  • Rheumatoid arthritis
  • Fluid retention due to pregnancy or menopause
  • Cyst or tumor in the carpal tunnel

People with computer equipment-based jobs or gamers are at an elevated risk of developing this syndrome since their work profile indicates a continuous use of hand equipment (3). This repeated movement, albeit slow/fast with the same movement of fingers/hands, is termed as “repetitive stress.” It usually includes the thumb and the index/middle finger and affects the dominant hand relatively severely.

A common issue after the onset of carpal tunnel syndrome might include a loose handgrip with difficulty in performing small tasks, such as grasping objects, etc.

Diagnosis and Treatment

The carpal tunnel syndrome is usually diagnosed by physical examination of the affected hands and arms to rule out other probable causes, followed by routine blood tests and X-ray examination. If these tests indicate carpal tunnel, then specific tests, such as the Tinel test, electrodiagnostic tests, are done to confirm the diagnosis.

The non-surgical treatments for carpal tunnel syndrome include the use of over-the-counter pain-relieving medications, splinting, prescription corticosteroids, and alternative therapies, including acupuncture, etc. The surgical treatment of carpal tunnel syndrome is one of the most common surgical procedures in the United States to relieve pressure off the median nerve.

References

  1. Padua L, Coraci D, Erra C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273-1284. doi:10.1016/S1474-4422(16)30231-9
  2. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Carpal-Tunnel-Syndrome
  3. Shiri R, Falah-Hassani K. Computer use and carpal tunnel syndrome: A meta-analysis. J Neurol Sci. 2015;349(1-2):15-19. doi:10.1016/j.jns.2014.12.037

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