The carpal tunnel is a narrow wrist structures formed at the bottom and sides by the carpal (wrist) bones, and at the top, covered by fibrous connective tissue (transverse carpal ligament). The median nerve passes through this tunnel in the wrist and controls the feeling on the palm side of the fingers and thumb.
Heredity – This trait often runs in families, as some people have smaller carpal tunnels than others.
Over use of hands and wrists – Over time, this causes synovium swelling.
Hormones – Hormonal changes play a key role in development of CTS.
Age – CTS risk goes up with age.
Certain medical conditions – These include rheumatoid arthritis, diabetes, and thyroid imbalance.
Bracing and splinting – To keep the wrist in a neutral position, the doctor may recommend a brace or splint. This prevents median nerve irritation, which occurs during sleep when the wrist is curled. A splint is often worn during the day to alleviate symptoms.
Medications – The most commonly prescribed drug class for CTS is non-steroidal anti-inflammatory drugs (NSAIDs). Ketoprofen, naproxen sodium, and ibuprofen are all in this class.
Corticosteroid injections – The doctor can inject the carpal tunnel with a corticosteroid agent, which offers pain relief and alleviates symptoms. Carpal tunnel steroid injection was found to reduce short-term symptoms in a recent clinical study. At two-year follow-up, local steroid injection was an effective means of treatment for CTS.
Surgical treatment – This is considered for severe cases of CTS. The decision to have surgery is based on the severity of the patient’s symptoms. Surgery is a choice for patients with long-standing CTS who experience wasting of the thumb muscles and constant numbness.
Short-wave diathermy (SWD) – This procedure was found to provide short-term relief in patients with CTS. It alleviates pain and improves hand function.