Pinched Median Nerve

A “pinched nerve” condition at the wrist is the usual diagnosis for Carpal tunnel syndrome.

Your knowledge of what Carpal tunnel syndrome is, who is at risk, how it is diagnosed and treated helps you find the right options for you.

Since carpal means wrist, an entrapment of the nerve at your wrist level is carpal tunnel entrapment and the nerve that is entrapped is median nerve.

Think of your wrist as a narrow tunnel with all kinds of large and small vehicles running through carrying all kinds of cargo. Your blood vessels carry oxygen and nutrients and remove metabolic waste. Your nerves carry signals to and from your hands through this tunnel. The tendons of your forearm muscles pass through this crowded tunnel to allow you to use your hand and fingers.

When your wrist becomes irritated and inflamed, it narrows and restricts the flow and motions. When the restriction pushes against your nerve, you feel it not always in pain but also in weakness and numbness.

Weakness, numbness usually come before the pain and they are the earliest symptoms. However as humans we ignore early signs and wait until pain arrives before we take actions.

Pain radiates around the wrist down to the hand and fingers and up to the forearm. It can refer to any spot along the median nerve.

Numbness runs through the palm and fingers and leaves the little finger out since the little finger gets signals from ulnar nerve.

Without care, nerve impingement turns to irreversible nerve damage, loss of muscle control and muscle atrophy. In these cases, the importance of your nervous system and strength training program becomes very clear.

The loss of muscle control impacts your ability to use your finger as well as your ability to  your wrist.

Who is at risk of Carpal tunnel syndrome?

The scale of risk is tilted toward women in carpal tunnel syndrome. Those who use their hands in repetitive motions like sewing, typing and assembly especially without appropriate support and training are at greater risk.

Change in body conditions including injuries, hormonal changes and diseases like arthritis, diabetes are at greater risk.

One of the more obvious hormonal change connection to carpal tunnel happens in pregnant women with carpal tunnel syndrome appearing in the third trimester and resolving after delivery.

Considering the severe consequence of nerve damage related to carpal tunnel syndrome, it is critical to consult with a professional in regards to the diagnosis and treatment.

One method professional health care providers use to determine nerve function is nerve conduction study.

In these studies, a small current is run through the skin to activate the median nerve. They highly sensitive equipment measures the speed of nerve impulse. If the median nerve is impinged, the signal is delayed or blocked.

The sensitivity of the these equipment could backfire. They sometimes indicate non-existing blockage that is one reason they are not a stand alone test.

In addition to showing impingement, nerve conduction studies could show how bad the impairments is and if the nerve in the Guyon’s canal are also under pressure.

These studies also show polyneuropathy that is more wide spread pattern of nerve-impairment beyond one nerve.

If nerve conduction studies do not show any nerve impairment, then your health care professional and you would know that the cause is something else.

Treatments of Carpal tunnel syndrome

Conservative treatments for carpal tunnel syndrome, especially in mild-to-moderate range include maintaining the wrist in a neutral position using wrist splints.

In a 2005 study published by University of Michigan showed that over a six week period, wearing customized wrist-splints at nights experienced less pain and the result lasted after more than a year.

Anti-inflammatory medications including aspirin, naproxen, and steroid drugs are among non-invasive treatments.

After this, the intrusive but still non-surgical treatments including steroid injections into the carpal tunnel itself become an option.

It is interesting to note that in a 2005 study at Mersin University in Turkey patients had better success with splints d than with steroid injections.

After depleting the conservative options, surgery may be the only choice for those who suffer from carpal tunnel syndrome pain and dysfunction.

Surgeons cut the overlying band that creates the constriction to open up the space.

In 2002 Vrije University in Amsterdam compared surgical treatment vs wearing wrist-splinting for six weeks. Eighteen months later 90% of the patients who received operation had retained success vs 75% of those who had splints.

Know your options, talk to your doctor and ask questions. Understand your risks in invasive procedures as well as delaying them.  Understand the benefits of conservative treatments as well as their limitations.

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