Carpal tunnel syndrome (CTS) is the name for a group of problems that includes swelling, pain, tingling, and loss of strength in wrist and hand. Ignoring symptoms of this common wrist problem can lead to permanent nerve damage. Women are three times more likely to have CTS than men. Pregnant women are at higher risk of developing this condition.
Carpal Tunnel Syndrome is a common condition due to pressure on the median nerve in your wrist causing numbness and tingling in your hand. Certain work activities (like frequent use of computer) are the most common risk factors. The carpal tunnel is a narrow passageway on the palm side of your wrist made up of bones and ligaments. The median nerve runs through this passageway along with tendons to the fingers and thumb.
The anatomy of your wrist, health problems and possibly repetitive hand motions can contribute to carpal tunnel syndrome. Proper treatment usually relieves the tingling and numbness and restores wrist and hand function.
Carpal Tunnel Syndrome (CTS)
CTS is the group of problems that includes swelling, pain, tingling, and loss of strength in wrist and hand. Our wrist is made of small bones that form a narrow groove or carpal tunnel. Tendons and a nerve called the median nerve must pass through this tunnel from forearm into hand. The median nerve controls the feelings and sensations in the palm side of thumb and fingers. Sometimes swelling and irritation of the tendons can put pressure on the wrist nerve, causing the symptoms of CTS. A woman’s dominant hand is the one that is usually affected. Nearly half of CTS sufferers have symptoms in both hands.
Pregnant women are especially at risk of developing this condition. In CTS, the median nerve gets compressed in the carpal tunnel. This can be due to a number of conditions, including rheumatoid arthritis, degenerative changes from an old fracture and even congenital reasons. Diabetes mellitus can also increase the susceptibility of the nerve to pressure. CTS has been associated with other conditions, such as obesity, hypothyroidism, acromegaly, a family history of carpal tunnel syndrome, work-related excessive and repetitive movements of the wrist and hand.
Without treatment, CTS can have a negative impact on a person's quality of life. Eventually, the median nerve can become severely damaged, and there may be permanent numbness in the fingers and permanent weakness in the muscles that are innervated by the median nerve. It is often linked to computer use. It was familiar to orthopedic surgeons since before the widespread use of computers.
Causes of Carpal Tunnel Syndrome (CTS)
Carpal tunnel syndrome can be associated with any condition that causes pressure on the median nerve at the wrist. The median nerve runs from your forearm through a passageway in your wrist (carpal tunnel) to your hand. It provides sensation to the palm side of your thumb and fingers, except the little finger. It also provides nerve signals to move the muscles around the base of your thumb. Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation resulting from rheumatoid arthritis.
Contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture; an overactive pituitary gland; an underactive thyroid gland; and rheumatoid arthritis. Mechanical problems in the wrist joint, work stress, repeated use of vibrating hand tools, fluid retention during pregnancy or menopause, or the development of a cyst or tumor in the canal also may contribute to the compression. Injury to the nerve also can cause carpal tunnel syndrome. Some common conditions that can lead to CTS include:
• Wrist fracture
• Swelling and inflammation resulting from rheumatoid arthritis.
• There is no single cause in many cases. It may be that a combination of risk factors contributes to the development of the condition.
• Arthritis or fracture near the wrist
• Overuse (as in typists, cashiers or certain athletes)
• Thyroid disease, particularly an underactive thyroid
• Work stress
• a cyst or tumor in the carpal tunnel
• an overactive pituitary gland
Mostly, carpal tunnel syndrome occurs without a clear reason. The condition affects women more often than men, perhaps because women normally have smaller carpal tunnels. It can occur in one or both hands.
Symptoms of Carpal Tunnel Syndrome (CTS)
CTS begins slowly with feelings of burning, tingling, and numbness in the wrist and hand. The areas most affected are the thumb, index and middle fingers. CTS symptoms may happen more often at night. Many woman suffering from CTS do not make the connection between a daytime activity that might be causing the CTS and the delayed symptoms. Also, many people sleep with their wrist bent, which may cause more pain and symptoms at night. As CTS gets worse, the tingling may be felt during the daytime too, along with pain moving from the wrist to arm or down to fingers. Pain is usually felt more on the palm side of the hand.
Next symptom of CTS is weakness of the hands that gets worse over time. Some woman with CTS find it tough to grasp an object, make a fist, or hold onto something small. The fingers may even feel like they are swollen even though they are not. Over time, this feeling will usually happen more often.
If not treated, those with CTS can have a loss of feeling in some fingers and permanent weakness of the thumb. Thumb muscles can actually waste away over time. Eventually, CTS sufferers may have trouble telling the difference between hot and cold temperatures by touch.
Effect of carpal tunnel syndrome on Women's Health
Women may be at greater risk of developing carpal tunnel syndrome because their carpal tunnel is smaller. Pregnant women are more susceptible to carpal tunnel syndrome because of hormonal changes and fluid retention which can increase the pressure in the carpal tunnel.
Women are three times more likely to have CTS than men. Although there is limited research on this issue. It may be that the wrist bones are naturally smaller in most women, creating a tighter space through which the nerves and tendons must pass. Some researchers are looking at genetic links that make it more likely for women to have musculoskeletal injuries such as CTS. Women also deal with strong hormonal changes during pregnancy and menopause that make them more likely to suffer from CTS. Generally, women are at higher risk of CTS between the ages of 45 and 54. There are other factors that can cause CTS, including certain health problems and, in some cases, the cause is unknown.
These are some of the risk factors that might affect carpal tunnel syndrome on Women's Health:
- Genetic - The carpal tunnel is smaller in some people than others.
- Repetitive movements - Woman who do the same movements with their wrists and hands over and over may be more likely to develop CTS. Woman with certain types of jobs are more likely to have CTS, including manufacturing and assembly line workers, grocery store checkers, violinists etc. Some hobbies and sports that use repetitive hand movements can also cause CTS, such as golfing, knitting, and gardening. Even long-term typing or computer use causes CTS.
- Injury - A sprain or a fracture of the wrist can cause swelling and pressure on the nerve, increasing the risk of CTS. Forceful and stressful movements of the hand and wrist can also cause trauma, such as strong vibrations caused by heavy machinery or power tools.
- Pregnancy - Hormonal changes during pregnancy and build-up of fluid can put pregnant women at greater risk of getting CTS, especially during the last few months. Most doctors treat CTS in pregnant women with wrist splints or rest, rather than surgery, as CTS almost always goes away following childbirth.
- Menopause - Hormonal changes during menopause can put women at greater risk of getting CTS. Also, in some postmenopausal women, the wrist structures become enlarged and can press on the wrist nerve.
- Breast cancer - Some women who have a mastectomy get lymphedema, the build-up of fluids that go beyond the lymph system's ability to drain it. In mastectomy patients, this causes pain and swelling of the arm. Some of these women will get CTS due to pressure on the nerve from this swelling.
- Critical medical condition – Woman having diabetes, hypothyroidism, lupus, obesity and arthritis are more likely to get CTS. In these patients, the normal structures in the wrist can become enlarged and lead to CTS.
Treatment for Carpal Tunnel Syndrome on women’s health
It is important to be treated by a doctor for CTS in order to avoid permanent damage to the wrist nerve and muscles of the hand and thumb. Most CTS patients get better after first-step treatments and the following tips for protecting the wrist. Treatments for CTS include the following:
- Wrist splint - A splint can be worn to support and brace your wrist in a neutral position so that the nerves and tendons can recover. A splint can be worn 24 hours a day or only at night. Sometimes, wearing a splint at night helps to reduce the pain.
- Rest - For woman with mild CTS, stopping or doing less of a repetitive movement may be beneficial.
- Medication - The use of nonsteroidal anti-inflammatory drugs (NSAIDs) may be required to control CTS pain. NSAIDs include aspirin, ibuprofen, and other non-prescription pain relievers. In severe cases, an injection of cortisone may help to reduce swelling. If CTS is caused by another health problem, doctor will treat that problem first. Like, if you have diabetes, it is important to know that long-term corticosteroid use can make it hard to control insulin levels.
- Surgery - CTS surgery is one of the most common surgeries done in the U.S. Generally, surgery is only an option for severe cases of CTS and/or after other treatments have failed for a period of at least six months. Open release surgery is a common approach to CTS surgery and involves making a small incision in the wrist or palm and cutting the ligament to enlarge the carpal tunnel. This surgery is done under a local anesthetic to numb the wrist and hand area and is an outpatient procedure.
According to the National Library of Medicine, there is no evidence that using a computer increases the risk of CTS, but ergonomic keyboards with an elevated and curved keyboard may reduce strain by helping to keep the hands in a neutral position. Some people recommend hand movement exercises, including yoga, and massages, but research has not confirmed that these are effective.