When mentioning problems related to illness or abnormalities concerning the hand, many people often think only of “Trigger Finger”, which occurs from overusing the hand, causing the tendon to lock, making it impossible to bend, straighten, or move the finger. But did you know? Among hand disorders, there is another equally serious condition called “Carpal Tunnel Syndrome.” If it occurs, it does not only affect the fingers but causes pain in the hand, making it difficult to use and may lead to numbness, weakness, and eventually loss of function. Therefore, for all of us who regularly use our hands for work, it is important to be aware of Carpal Tunnel Syndrome to better protect ourselves from this disease.
What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome, or sometimes called wrist ligament compression of the nerve, is a condition that often occurs in people who “use their hands extensively for work”, such as office workers who work on computers and type constantly, factory workers who repeatedly use their hands for packing, twisting, assembling for long periods, and housekeepers who regularly perform heavy manual labor. When the hands are overused, the carpal tunnel thickens, and the wrist tendons become inflamed and swollen, compressing the nerve passing through the carpal tunnel, causing nerve inflammation and resulting in pain.
What symptoms indicate a risk of Carpal Tunnel Syndrome?
The symptoms of Carpal Tunnel Syndrome start with hand pain, followed by numbness in the thumb, index finger, middle finger, and half of the ring finger. If left untreated without resting the hand, the symptoms will worsen. The nerve will gradually be compressed, restricting blood flow to the extremities, preventing muscle strength from reaching the hand. The hand will progressively weaken in both the fingers and palm. Grasping and clenching will become increasingly difficult, and in severe cases, the hand may become flat with muscle atrophy, making it impossible to use the hand for normal activities.
The symptoms of Carpal Tunnel Syndrome may come and go because when pain or numbness occurs, the person stops using the hand, causing symptoms to subside. However, when heavy hand use resumes, symptoms can recur. Therefore, if you experience hand pain, numbness, or weakness, you should promptly consult a doctor for proper treatment.
Are there other risk factors for Carpal Tunnel Syndrome?
The likelihood of developing this condition depends not only on heavy and continuous hand use but also on individual hand characteristics. People have different growth patterns of bones, muscles, joints, tendons, and ligaments, and anatomical positions vary. The carpal tunnel resembles a cave roof with a nerve passing underneath. Therefore, hand width and shape differences affect the ease of developing Carpal Tunnel Syndrome, even if the hand use intensity is the same. Additionally, this condition is more common in women than men and is frequently found in housekeepers.
How is Carpal Tunnel Syndrome treated?
Treatment for Carpal Tunnel Syndrome depends mainly on the severity of the condition, with three levels of management as follows:
- Resting the hand: Regardless of the task, once pain is diagnosed as Carpal Tunnel Syndrome, all hand activities must be stopped, and anti-inflammatory medication taken. The doctor may also recommend wearing a soft splint to rest the wrist. If the condition is not severe, it can heal, but after recovery, lifestyle changes are necessary to avoid returning to heavy hand use, which could cause recurrence.
- Steroid treatment: Steroid injections help reduce inflammation of the tendons immediately, reducing swelling. With less swelling, nerve compression decreases, and symptoms of pain, numbness, and weakness improve. This treatment works quickly, but if hand use behavior is not changed and the patient neglects care after improvement, the condition may recur. It is important to note that frequent steroid injections can cause side effects such as tendon degeneration and rupture. There is also a risk of nerve injury from the needle. Additionally, steroid injections may complicate future surgeries technically.
- Surgical treatment: Surgery is considered when medication and rest do not relieve pain. There are two surgical methods:
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- Method 1: Open surgery involves a 3-5 centimeter incision on the palm.
- Method 2: Endoscopic surgery involves a small 1-centimeter incision at the wrist crease to release the compressed ligament using advanced technology and specialized surgeons. Advantages include a smaller wound, less tissue damage, less postoperative pain, faster recovery, no easily visible scars, and no painful scars that often cause hand function problems after surgery. This procedure takes less time, uses only local anesthesia, and patients can go home immediately after surgery. Postoperatively, the wound is bandaged, and a splint is applied to reduce pain but can be removed for bathing. The splint is permanently removed after about one week, and the hand can be used but heavy use is not allowed for about one month to allow recovery.
However, although surgery is the most effective treatment, patients can still develop Carpal Tunnel Syndrome again if they do not change their hand use habits and continue heavy work. Moreover, endoscopic surgery is not suitable for everyone. Some patients may require open surgery, such as those who have had previous endoscopic surgery but experienced recurrence, or patients with kidney disease undergoing regular dialysis. In these cases, Carpal Tunnel Syndrome is not caused by heavy hand use but by kidney disease, so open surgery is necessary due to more complex treatment requirements.
Carpal Tunnel Syndrome is a common condition that anyone who works can develop because we all use our hands daily for work and activities. Therefore, regularly monitoring symptoms and abnormalities is crucial. If you experience pain, numbness, weakness, or difficulty grasping, you should promptly consult a doctor for advice and treatment to recover fully. It is essential to adjust hand use behavior appropriately to avoid overuse, as this is the only way to prevent recurrence. However, for some professions that require repetitive heavy hand use inevitably, considering a job change may be a solution to avoid lifelong recurring pain.
