But there's little evidence to say they can treat the cause of CTS, so it's important not to rely on them.
If they're not sure it's CTS, they may refer you to hospital for tests, such as an ultrasound scan. If a wrist splint does not help, your GP might recommend a steroid injection into your wrist. This brings down swelling around the nerve, easing the symptoms of CTS.
Steroid injections are not always a cure. CTS can come back after a few months and you may need another injection. If your CTS is getting worse and other treatments have not worked, your GP might refer you to a specialist to discuss surgery.
Check if you have carpal tunnel syndrome
Surgery usually cures CTS. You and your specialist will decide together if it's the right treatment for you. An injection numbs your wrist so you do not feel pain local anaesthetic and a small cut is made in your hand. The carpal tunnel inside your wrist is cut so it no longer puts pressure on the nerve.
CTS happens when the carpal tunnel inside your wrist swells and squeezes 1 of your nerves median nerve. Page last reviewed: 22 January Next review due: 22 January Carpal tunnel syndrome. Check if you have carpal tunnel syndrome CTS The symptoms of carpal tunnel syndrome include: an ache or pain in your fingers, hand or arm numb hands tingling or pins and needles a weak thumb or difficulty gripping These symptoms often start slowly and come and go.
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They're usually worse at night. How to treat carpal tunnel syndrome CTS yourself CTS sometimes clears up by itself in a few months, particularly if you have it because you're pregnant. In these instances, especially when untreated, individuals can experience hand weakness, impaired use of the hand, and loss of sensation in their hand due to permanent nerve and muscle damage.
Carpal tunnel syndrome may occur in patients who are pregnant, overweight or have various medical conditions, including thyroid disease, diabetes or arthritis, or injuries such as wrist fractures.
How to treat carpal tunnel syndrome (CTS) yourself
It is still debated whether repetitive work activities cause carpal tunnel syndrome, but it is thought that some repetitive hand activities, especially motions that can produce vibrations, can worsen the symptoms. Just as frequently, the syndrome occurs on its own.
However, many other conditions also can be responsible for symptoms of pain, swelling, numbness or weakness in the hands, such as diseases of the nerves located anywhere from the neck to the wrist. The pain and swelling in the hand joints and wrists caused by arthritis also can be responsible.
Carpal tunnel syndrome
For example, pain at the base of the thumb is commonly caused by osteoarthritis. Tendonitis — an inflammation of the tendons that connect muscles to bones — can cause pain, swelling, and impaired use of the hand or wrist. Health care professionals should exclude these and other diseases before diagnosing carpal tunnel syndrome.
Diagnosis of carpal tunnel syndrome based on an accurate description of the symptoms a patient is experiencing. During physical examination, testing may identify weakness of the muscles supplied by the median nerve in the hand, including some thumb muscles affected by the syndrome. There may be decreased sensation in the hand when pricked with a pin or lightly touched. Bending the wrist at a 90 degree angle for one minute may cause symptoms to appear in the hand Phalen test , or tapping on the wrist with a reflex hammer may cause an electric shock-like sensation Tinel Sign.
Late in the disease, the muscles might be thinning or declining at the base of the thumb. Health care professionals can confirm the diagnosis of carpal tunnel syndrome and determine its severity with a two-part electrical test called the nerve conduction test.
The nerve conduction test is the strongest evidence for carpal tunnel syndrome.
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During the first part of the test, a small electrode that generates a mild electrical current is placed on the skin on the elbow side of the tunnel. This current stimulates the median nerve. The impulse from the stimulation travels down the nerve, through the tunnel, and to the hand — where the doctor will measure how long it took for the impulse to get there.
If the median nerve is damaged, the impulse will take longer than expected to get to the hand.
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The worse the nerve damage is, the longer it will take for the impulse to get to the hand. The second part of the test is called electromyography. It measures how badly the muscle is functioning. A small needle is placed in various muscles that receive impulses from the median nerve. The electrical impulses in the muscle are measured when the muscle is not being used and when the muscle is being used.
If the median nerve is severely squeezed, these muscles can be affected and will not perform normally during the test. Diagnostic ultrasonography and MRI have been used to help diagnose carpal tunnel syndrome and exclude other causes of hand and wrist symptoms. These technologies can identify swelling of the median nerve and abnormalities of the tunnel wall, its contents and surrounding area.
They can also help determine why the median nerve is being squeezed, or compressed. For example, inflammation of structures in the tunnel like inflamed tendons might be causing the median nerve to be compressed. This can occur in rheumatoid arthritis.
Other tendon abnormalities, such as excessive fat in the tunnel also called a ganglion also can be seen using MRI. Pain medications such as acetaminophen and nonsteroidal anti-inflammatory drugs can be used for symptom relief. Placing a splint on the affected wrist, especially at night, can help keep the wrist straight during the night and decrease the pressure on the median nerve. These splints are available in most drug stores and may relieve symptoms, especially in milder cases.
A cortisone injection into the carpal tunnel area often is helpful in relieving symptoms for weeks to months at a time and can be repeated.
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