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Median Nerve compression (Carpal Tunnel Syndrome)
The median nerve crosses through the wrist into the hand via a small tunnel in the wrist called the carpal tunnel. Bones and stiff connective tissue form the boundaries of the carpal tunnel. Narrowing of this tunnel can be caused by tendon inflammation, fractures or swelling in the hand can put pressure on the median nerve causing a constant, dull ache radiating to the thumb, index and middle finger as well as pins and needles and numbness and in the extreme weakness of the thumb musculature. The pain will tend to worsen at night. Tapping over the wrist on the palm side may reproduce symptoms in the hand where Carpal Tunnel Syndrome is present. Rest and anti-inflammatory measures may decrease pain; surgery may be indicated in chronic cases.
Carpal Tunnel Syndrome (CTS) is a compression neuropathy, i.e. a pinching of the median nerve within the wrist.
This disabling syndrome occurs more often in women than men, by a ratio of 3 to 1, usually between the ages of 30 and 50 years. Also, carpal tunnel syndrome is seen more frequently in people who tend to do forceful repetitive types of work, such as grocery store checkers, assembly line workers, meat packers, typist, accountants, writers, etc. Most patients generally visit their doctor with these complaints, and the diagnosis is confirmed after physical examination and appropriate nerve testing.
Treatment for carpal tunnel syndrome depends upon the stage of the disease. In the early stage, the syndrome can be reversible and is most often treated with appropriate modification in activities, a removable wrist brace, and anti-inflammatory medicines. In moderate stages of the disorder, especially if the numbness and pain continues in the wrist and hand, a cortisone injection into the carpal tunnel can be extremely beneficial. Surgical intervention is only indicated in those patients in whom non-operative treatment has failed to eliminate their symptoms. In patients with advanced disease, and especially in those who have profound weakness or muscle atrophy, surgical intervention should be done early. Carpal tunnel syndromeshould not be left untreated because it can eventually cause permanent nerve damage.
Pressure on the Ulnar Nerve (Ulnar Neuritis)
The ulnar nerve may be compressed in the wrist at the inner side of the hand. This problem is usually caused by compression and friction from altered hand postures such as during cycling. Symptoms include pain, pins and needles radiating to the little and ring finger as well as muscle weakness when trying to spread the fingers. Rest and anti-inflammatory measures may decrease pain; surgery may be needed in chronic cases.
The ganglion is an inflammation and proliferation of nerve tissue over the site of a nerve. Ganglions are common over the nerves in the wrist and may appear over the front or back of the wrist. The ganglion will appear as a bump in the wrist and may or may not be accompanied by symptoms in the wrist. Symptoms may include local pain and swelling. The ganglion may not need to be treated if it is unsymptomatic. If symptoms persist a doctor should be consulted.