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Carpal Tunnel Syndrome
Carpal tunnel syndrome is caused by compression of the median
nerve as it passes through the wrist into the hand. Sufferers often experience tingling
in their middle fingers and have difficulty performing activities like buttoning
a shirt or gripping a hair brush.
The median nerve travels under a ligamentous structure known as the flexor retinaculum (aka transverse carpal ligament). Numerous flexor tendons of the fingers also pass through this ‘tunnel’. If these tendons (or their synovial sheaths) swell, this makes the carpal tunnel ‘crowded’, and the median nerve becomes compressed.
Compression of the median nerve is also influenced by the position of the wrist. When the wrist is in a flexed position, this compresses the nerve further (that’s why sufferers often experience the problem when they wake in the morning or when they perform activities that ‘clenches’ their hand).
Carpal tunnel syndrome is usually treated with resting night splints. These hold the hand in a slightly extended position which takes the pressure off the median nerve. Sometimes patients also wear wrist supports during the day. In severe cases, surgery can be required.