Carpal tunnel syndrome (CTS) is a common condition that affects the hand and wrist, characterized by compression of the median nerve as it passes through the carpal tunnel—a narrow passageway in the wrist formed by bones and ligaments. When the median nerve becomes compressed or irritated, it can lead to a variety of symptoms, including pain, numbness, tingling, and weakness in the hand and fingers. CTS is often associated with repetitive motions. Treatment options include wrist splints, medications, and physical therapy.
Causes of Carpal Tunnel Syndrome
Repetitive Hand and Wrist Movements
Prolonged or repetitive hand and wrist movements, such as typing, assembly line work, and manual labor, can contribute to the development of carpal tunnel syndrome. Repetitive movements may cause irritation and inflammation of the tendons and surrounding tissues within the carpal tunnel, leading to compression of the median nerve.
Certain anatomical factors, such as a narrow carpal tunnel, congenital abnormalities, or wrist fractures, may increase the risk of developing carpal tunnel syndrome. Individuals with smaller wrist dimensions or structural variations in the carpal bones may be more susceptible to nerve compression and symptoms of CTS.
Underlying medical conditions, including arthritis, diabetes, obesity, thyroid disorders, and hormonal imbalances, can predispose individuals to nerve compression and peripheral neuropathy. Systemic conditions that affect nerve function or impair circulation may exacerbate symptoms of carpal tunnel syndrome and contribute to nerve damage.
Acute traumatic injuries, such as wrist fractures, dislocations, or soft tissue trauma, can cause swelling, inflammation, and compression of the median nerve within the carpal tunnel. Traumatic injuries may result from falls, motor vehicle accidents, sports injuries, or occupational hazards.
Symptoms of Carpal Tunnel Syndrome
The symptoms of carpal tunnel syndrome can vary in severity.
Numbness and Tingling
- Numbness, tingling, or pins-and-needles sensations often occur in the thumb, index finger, middle finger, and ring finger.
- Sensory disturbances may occur predominantly at night or during activities that involve wrist flexion or repetitive hand movements.
Pain and Discomfort
- Dull, aching pain or discomfort in the wrist, palm, and affected fingers is common,
- Pain often gets worse with repetitive motions or prolonged wrist flexion.
- Pain may radiate up the forearm or toward the fingertips.
- Weakness, clumsiness, and decreased grip strength in the affected hand can interfere with fine motor task.
- Muscle atrophy (wasting) may occur in severe cases of carpal tunnel syndrome.
- Symptoms of carpal tunnel syndrome may worsen at night or upon awakening, causing sleep disturbances and discomfort.
Treatment of Carpal Tunnel Syndrome
Conservative treatment options for carpal tunnel syndrome include rest, activity modification, and wearing wrist splints to maintain neutral wrist position and alleviate pressure on the median nerve. Avoiding aggravating activities, such as repetitive typing or gripping, can help reduce inflammation and relieve symptoms.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may be used to alleviate pain, reduce inflammation, and improve symptoms. Oral or topical analgesics, muscle relaxants, and neuropathic medications may be prescribed to manage pain and discomfort associated with nerve compression.
Local corticosteroid injections into the carpal tunnel can provide temporary relief of symptoms by reducing inflammation and swelling around the median nerve.
Physical therapy, including exercises and therapeutic ultrasound, may help improve nerve mobility, reduce scar tissue formation, and alleviate symptoms of carpal tunnel syndrome. Occupational therapy interventions focus on ergonomics, joint protection, and activity modification to minimize stress on the wrist.
Carpal tunnel release surgery may be considered for individuals with severe symptoms that do not respond to conservative treatments. Carpal tunnel release surgery involves dividing the transverse carpal ligament to decompress the median nerve and alleviate symptoms of nerve compression.
Significance for Workers’ Compensation in Georgia
In Georgia, carpal tunnel syndrome may be considered a compensable occupational injury if it arises out of and in the course of employment, and if it is directly attributable to job-related duties, activities, or exposures. Workers who develop carpal tunnel syndrome as a result of repetitive work tasks, ergonomic hazards, or occupational exposures may be entitled to medical treatment and compensation for lost wages under the Georgia Workers’ Compensation Act.
To establish a claim for carpal tunnel syndrome in a workers’ compensation case, it is essential to demonstrate a causal relationship between the individual’s job duties or occupational exposures and the onset or exacerbation of carpal tunnel symptoms.
Carpal tunnel syndrome is a debilitating condition that can significantly impact an individual’s ability to perform work-related tasks and activities of daily living. Early recognition and prompt treatment are essential. Treatment options include wrist splints, medications, and physical therapy. In severe cases, surgery may be necessary.