CTS (Carpal Tunnel Syndrome), Causes, Diagnosis, Treatment, Prevention, Complications

CTS (Carpal Tunnel Syndrome), Causes, Diagnosis, Treatment, Prevention, Complications

Carpal tunnel syndrome (CTS) is a condition that causes tingling, pain, or weakness in the hand and wrist. This syndrome occurs when the nerves inside the wrist are compressed or compressed.

The carpal tunnel is a narrow passageway inside the wrist formed by the wrist bones (carpal bones) and connective tissue between bones (ligaments). In the carpal tunnel, there is the median nerve, which controls the muscles of the fingers and receives stimulation from the skin in the hand area.

Carpal tunnel syndrome (CTS) occurs when the carpal tunnel becomes narrow as the surrounding tissue swells and presses on the median nerve. Although it can happen to anyone, women are more at risk of developing this disease than men.

This condition is also different from cubital tunnel syndrome, which is the pinching of the ulnar nerve in the nerve tunnel at the elbow. In addition to similar symptoms, carpal tunnel syndrome is also different from de Quervain's tenosynovitis, which is inflammation of the tendon at the base of the thumb.

Carpal Tunnel Syndrome Causes and Symptoms

The cause of carpal tunnel syndrome (CTS) is compression of the nerves in the wrist. Pressure on this nerve can occur due to several conditions. One of them is a fracture of the bone in the wrist, causing swelling of the surrounding tissue.

CTS can cause symptoms such as tingling, pain, burning sensation, and numbness in the hands and fingers. In addition to these sensory complaints, people with CTS also experience weakness in the hand muscles. Symptoms of CTS can come and go so that it interferes with the sufferer in their daily activities.

Carpal Tunnel Syndrome Treatment and Prevention

CTS can be overcome by avoiding activities that use the hands or fingers a lot. The patient can also use a wrist support (wrist support). If the symptoms do not improve or even get worse, consult a doctor for further treatment.

Carpal tunnel prevention is done by reducing the risk of injury to the hand and wrist. Some of the things that need to be done are:

• Avoid bending the wrist.
• Stretch your wrist.
• Don't grip your hand too tightly.

Symptoms of CTS (Carpal Tunnel Syndrome)

Symptoms of carpal tunnel syndrome (CTS) can occur in both hands. However, the initial symptoms usually occur in one hand, especially the hand that is often used to carry out daily activities.

Some of the symptoms of CTS are:

• Tingling in the palms and fingers, except for the little finger
• Pain
• Burning sensation
• Numb

Symptoms of CTS may go away and come back. When the symptoms reappear, the complaints that are felt can get worse so that the sufferer has difficulty carrying out daily activities, such as reading the newspaper or using a smartphone.

In addition, symptoms generally get worse at night. The pain felt by the sufferer can also spread to the elbow, even the shoulder, over time.

In addition to pain, tingling, or numbness, CTS can also make hand and finger muscles weak. Weak hand muscles can cause sufferers to experience the following complaints:

• Difficult to hold things
• Frequently dropping things
• Difficulty performing fine motor movements, such as buttoning a shirt

When to go to the doctor

Check with your doctor if you experience any of the above symptoms, especially if the symptoms do not improve immediately and are interfering with your daily activities or sleep patterns.

Early examination is needed to speed up treatment and prevent complications in the form of permanent nerve damage and long-term pain (chronic pain).

Diagnosis of CTS (Carpal Tunnel Syndrome)

To diagnose carpal tunnel syndrome, the doctor will ask about the symptoms experienced and the patient's medical history. After that, the doctor will conduct an examination of the sensory nerves and muscle strength of the patient's hand.

The doctor may also pat or bend the patient's wrist to see if this triggers the symptoms of CTS.

In addition to a physical examination, the doctor will perform several additional tests to confirm the diagnosis of CTS. The following are some of the checks that can be performed:

• X-rays, to find out if there are other conditions that cause wrist pain
• Ultrasound, to see the condition of the tissue and bones around the wrist so that the doctor can find out if there is a compressed nerve
• MRI, to see the condition of the soft tissues of the wrist
• Electromyography, to measure the electrical activity that flows to the nerves of the hand so that it can detect nerve damage
• Blood tests, to determine the cause of CTS which can occur due to certain diseases, such as rheumatoid arthritis, diabetes, and hypothyroidism

Treatment of CTS (Carpal Tunnel Syndrome)

Carpal tunnel syndrome (CTS) often doesn't require any special treatment, as it usually goes away on its own in a few months. If it needs to be treated, then the treatment carried out depends on the severity and how long the patient has had this condition.

If CTS occurs during pregnancy, symptoms will generally disappear on their own within a maximum of 6 months after delivery. However, if CTS is severe enough, doctors can provide treatment.

To prevent CTS from getting worse, patients need to avoid activities that involve a lot of finger and hand movement. If the symptoms of CTS do not improve after a few weeks, there are several methods of treatment that can be given by the doctor, namely:

Use of Wrist Support

Wrist support is used to place the wrist so that it is always straight and does not bend. This tool is usually installed at night and used for a minimum of 3 weeks.

Drugs

Doctors can give some medicines, namely non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. NSAIDs, such as ibuprofen and diclofenac, are given to relieve pain.

Meanwhile, corticosteroids are given to reduce inflammation and swelling in the carpal tunnel so that it can reduce pressure on the nerves that cause pain. Generally corticosteroid drugs are given in the form of injections.

Operation

Surgery is performed if other treatment methods do not improve the patient's condition. Surgery for CTS is known as carpal tunnel decompression. This procedure can be performed with open surgery or keyhole surgery (endoscopy).

After CTS surgery, the patient's hand will be bandaged and supported up to chest level. The patient will be asked to move his or her fingers to reduce swelling and prevent stiffness. Hand function generally recovers within 1-4 months, depending on how severe the patient's neurological condition was before surgery.

Patients are still allowed to use the operated hand to carry out daily activities, such as bathing, changing clothes, eating, driving a car, and lifting light items, but need to use wrist support for several weeks.

Complications of CTS (Carpal Tunnel Syndrome)

There are several complications that can occur due to carpal tunnel syndrome that does not go away. Some of the complications are:

• Permanent damage to wrist nerves
• Ongoing pain (chronic pain)
• Wasting or shrinking of the muscles (muscle atrophy)

Not only due to CTS disease itself, complications can also occur due to CTS surgery, namely:

• Surgical wound infection
• Bleeding
• Scars in the surgical area
• Nerve injury

Therefore, discuss with your doctor about the benefits and risks of treatment that will be undertaken, both with drugs and surgery.

Prevention of CTS (Carpal Tunnel Syndrome)

Carpal tunnel syndrome is difficult to prevent. The best effort that can be done is to reduce the risk of CTS, such as:

• Reduces strong grip on the hand
• Doing stretches, such as stretching your fingers, before and after activities
• Resting the wrist, to avoid pressure on the carpal tunnel
• Avoid bending the wrist
• Maintain a sleeping position with wrists straight
• Keep your hands warm, because the cold can numb your hands
• Maintain good posture
• Using pads when using a computer mouse

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