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Carpal tunnel syndrome

Oftentimes, people complain of pain, tingling, or numbness in the hands and assume that the diagnosis is carpal tunnel syndrome (CTS). In fact, I had a patient today tell me that her CTS was acting up but then went on to describe symptoms in an area of the hand that is not affected by CTS.

True carpal tunnel syndrome affects the thumb, index finger, middle finger, and/or part of the ring finger. The median nerve is compressed in CTS and innervates this area of the hand on the palm side. 

Carpal tunnel syndrome normally begins with a pins and needle feeling, often at night or first thing in the morning.  This may progress to pain during the day, specifically when using your hands or holding things. As CTS progresses, the pins and needles can turn more to numbness and you may start to notice weakness when doing certain motions or activities.

The pain and weakness make it difficult to do everyday tasks, even leading to the inability for some people to work. The most common cause is repetitive stress causing inflammation in the area of the wrist that houses the median nerve (the carpal tunnel).

Treatment for carpal tunnel starts conservatively with avoiding repetitive motions (if possible), wearing a brace, ice, getting adjusted, acupuncture, stretching, B6 vitamins and anti-inflammatories (either natural or OTC). More invasive treatments include cortisone injections to decreased inflammation and worst case scenario, surgery.