It could be Carpal tunnel syndrome. It happens when pressure on the median nerve makes your hand tingly, numb, weak, or painful.
Causes Carpal tunnel syndrome occurs when a combination of health factors and activities puts pressure on the median nerve as it passes through the carpal tunnel in your wrist.
- These factors include:
- Conditions or illnesses that can cause or contribute to arm pain or swelling in the joints and soft tissues in the arm, or to reduced blood flow to the hands. These include obesity, rheumatoid arthritis, gout, diabetes, lupus, and hypothyroidism.
- Repeated hand and wrist movements. They can cause the membranes surrounding the tendons to swell (tenosynovitis).
- Broken wrist bones, dislocated bones, new bone growth from healing bones, or bone spurs.
- Forceful or repetitive hand movements.
- Hand-arm vibration.
- Working for long periods in the same or awkward positions.
Symptoms
- Numbness or pain in your hand, forearm, or wrist that awakens you at night. (Shaking or moving your fingers may ease this numbness and pain.)
- Occasional tingling, numbness, “pins-and-needles” sensation, or pain. The feeling is similar to your hand “falling asleep.”
- Numbness or pain that gets worse while you are using your hand or wrist. You are most likely to feel it when you grip an object with your hand or bend (flex) your wrist.
- Occasional aching pain in your forearm between your elbow and wrist.
- Stiffness in your fingers when you get up in the morning.
- Symptoms most often occur in the thumb, the index finger, the middle finger, and half of the ring finger. Symptoms are usually worse at night and your grip will weaken as the condition progresses. Eventually you will notice muscle atrophy (wasting away) of the thenar (thumb) muscles and loss of hand function or clumsiness.
Risk Factors
- Health problems or illnesses that can cause arm pain or swelling in the joints and soft tissues in the arm, or reduce the blood flow to the hands. These include obesity, rheumatoid arthritis, diabetes, lupus, hypothyroidism, and multiple sclerosis.
- Being female. Women between the ages of 40 and 60 have the highest risk. Pregnant women near the end of their pregnancies often have short-term symptoms. Women taking birth control pills, going through menopause, or taking estrogen are also thought to be at risk.
- Hand and wrist movements and activities that require repeated motions, especially in awkward positions.
- Smoking. It may contribute to carpal tunnel syndrome by affecting the blood flow to the median nerve.
- Broken wrist bones, dislocated bones, new bone growth from healing bones, or bone spurs. These can take up space in the carpal tunnel and put more pressure on the median nerve.
- Tumors and other growths (such as ganglions). These uncommon causes of carpal tunnel syndrome are usually benign.
- Normal wear and tear of the tissues in the hand and wrist caused by aging.
TREATMENT
- Physical therapy. This includes
- Ultrasound.
- Carpal bone mobilization and flexor retinaculum stretching to open the carpal tunnel.
- Nerve and tendon gliding exercises to ensure full unrestricted median nerve motion is available.
- Muscle and soft tissue extensibility.
- Cervicothoracic spine to correct any referral from the cervical spine.
- Grip and pinch, thumb abduction and forearm strengthening in later phases.
- Comprehensive upper limb, wrist and hand ROM strengthening and endurance exercises.
- Posture, fine motor and hand dexterity exercises.
Activity changes. Symptoms often occur when your hand and wrist are in the same position for too long—particularly when your wrist is flexed or extended. If your job or recreational activities aggravate your symptoms, changing or modifying these activities can help slow or stop progression of the disease. In some cases, this may involve making changes to your work site or work station.
Medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation.
Home treatment, such as changing or avoiding activities that may be causing symptoms and wearing a wrist splint.
