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Carpal Tunnel Syndrome

Medical data is for informational purposes only. You should always consult your

family physician, or one of our referral physicians prior to treatment.

Note: The book Arthritis: Osteoarthritis and Rheumatoid Disease

Including Rheumatoid Arthritis by Anthony di Fabio and Gus Prosch, Jr.,

M.D. should be considered a companion book to this one. See http://

www.arthritistrust.org

Carpal Tunnel Syndrome

by Anthony di Fabio

The Roger Wyburn-Mason and Jack M. Blount Foundation for the

Eradication of Rheumatoid Disease

akaThe Arthritis Trust of America

7376 Walker Road, Fairview, TN 37062

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is an entrapment of a middle (median) nerve com-

pressed between the wrist (longitudinal carpal ligament) and hand muscles and

a ligament that is perpendicular, passing across the wrist (transverse carpal liga-

ment).

The carpal tunnel is a canal that encloses nine finger tendons, connective

tissue, arteries, veins, and the median nerve. An arch of this canal is made by

eight wrist bones that also form an arc. The median nerve passes beneath this

arc, and the carpal ligment extends over the eight wrist bones.

The median nerve conducts impulses from the brain to the thumb, forefin-

ger, middle finger, and half of the ring finger. When compressed, this nerve may

cause pain, in the wrist, palm and/or forearm, and may cause an abnormal sen-

sation in the palm and first three digits and the lateral half of the fourth digit.

Loss of strength in turning outward (abduction) or opposition of the thumb may

result in, and also atrophy certain muscles.

De Quervain's Disease

Identical to Carpal Tunnel Syndrome, according to John Marion Ellis,

M.D., is a condition of painful tenosynovitis of the common tendon sheath of

two tendons on the side and top of the thumb.

A patient experiences severe pain where the thumb joins the base of the

hand, accompanied by stiffness and weakness of pinch. Any attempt at rotation

of a thumb towards the base of the little finger causes pain to radiate from the

thumb up the forearm.

Patients with De Quervain's disease also suffer from intense pain in the

elbows and shoulders.

Distribution of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome affects all ages of adults, but women are af-

fected, usually after age 35,

more than men, particularly in those who've had a

hysterectomy without oophorectomy, or those who have gone through meno-

pause between 6 to 12 months earlier.

With women, it's origin is not always clear, but is common in later months

of pregnancy, and often remits following delivery.

With men and women, it can be associated with occupational performance,

such as house painting, typing, farming, spinning, carpentery, and other repeti-

tive tasks.