Carpal Tunnel Syndrome - Medical Malpractice Lawyers

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Carpal Tunnel Syndrome - Medical Malpractice

Carpal tunnel syndrome is a disease in which the median nerve is entrapped in the tendons of the wrist that form the "carpal tunnel". It is a common injury that is generally caused by repetitive motion of the wrist although obesity can play a role in the disease. People who perform a specific job affecting the wrist all day long at work are most likely to get this disease. The carpal tunnel is bound by tendons, ligaments and bone within the volar surface of the radial aspect of the wrist. Back and forth movement makes for the most chance of getting carpal tunnel syndrome.

The symptoms of carpal tunnel syndrome can interfere with the functioning of the hand and wrist. It involves pain in the wrist along with pain, tingling or numbness of the area of the hand supplied by the median nerve, which is the palm of the hand, the thumb and the first three fingers, except for the lateral aspect of the third finger. The fourth finger is supplied by the ulnar nerve and is unaffected. The pain is made worse by flexing the wrist forward. If you shake out the hand, you can temporarily get some relief but as the disease worsens, nothing seems to help.

The pain is localized to the hand in mild cases but worsened cases have the pain radiate up the median nerve to as high as the shoulder. It affects usually the palmar aspect of the upper arm and forearm. The hands become very weak and you often drop things you attempt to hold.

As mentioned, the cause of carpal tunnel syndrome is pressure placed upon the median nerve in the carpal tunnel of the wrist. Women are more affected by this disease than men and both motor and sensory function are affected. The hand is affected more often than the wrist and the forearm. Usually the thumb is the most affected.

Rheumatoid arthritis and other arthritic conditions can make carpal tunnel much worse. If you have fluid retention during a pregnancy, you can get temporary carpal tunnel syndrome. If you are overweight, carpal tunnel is more likely and those with amyloid deposits in the body, hypothyroidism or menopause, you can get carpal tunnel syndrome. Some are born with a narrower carpal tunnel than other people so they get the disease more likely.

Carpal tunnel syndrome is more often than not related to one's work and is common in clerical jobs, industrial jobs, supermarket cashiers and any others that have to move the wrist back and forth. Men or women who use wood chippers or grinders suffer from chronic vibration to the wrist so they are at higher risk of getting carpal tunnel. Chainsaws can lead to carpal tunnel syndrome due to the vibration.

Risk factors of the disease include being of a female gender which increases the risk of getting carpal tunnel disease threefold. Hereditary factors can play a role. Obesity, thyroid disease, diabetes and rheumatoid arthritis are also risk factors for the disease. Pregnancy is a temporary risk factor.

The diagnosis of carpal tunnel syndrome depends on a careful history and physical exam. Numbness of the hand is assessed as well as the strength of the hand. The doctor flexes the wrist and, if the symptoms intensify, the problem is likely carpal tunnel syndrome. The doctor can also tap on the median nerve. If there is a "zing" or pain in the median nerve distribution, it is likely carpal tunnel syndrome. Nerve conduction studies of the hand can be done in order to see what's happening with the median nerve.

The treatment of carpal tunnel syndrome can include anything from splinting to surgery. Splinting involves using a volar splint that is tipped back slightly to free up the nerve. It can be used in both wrists if necessary. Steroids can be injected into the median nerve to shrink the inflammation and swelling of the nerve. Surgery to open up the carpal tunnel is used when nothing else helps. It is known as carpal tunnel repair. The ligaments are cut and moved out of the way of the median nerve, which should repair itself after that.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here