Carpal Tunnel Syndrome
What Happens in Severe Cases of Carpal Tunnel Syndrome?
As carpal tunnel syndrome becomes more severe, a person may have decreased grip strength with atrophy, or wasting, of the muscles in the hand. Pain and muscle cramping become more severe. The median nerve itself begins to deteriorate with chronic irritation or pressure around it. This results in a slowing of nerve impulses, loss of feeling in the fingers, and a loss of strength and coordination at the base of the thumb. If the condition is not treated, it could result in permanent deterioration of muscle tissue and loss of hand function.
Do Certain Medical Conditions Make People More Likely to Develop Carpal Tunnel Syndrome?
Common medical conditions associated with carpal tunnel syndrome include obesity, pregnancy, hypothyroidism, arthritis, and diabetes. Trauma can also cause carpal tunnel syndrome. In the case of pregnancy, the symptoms usually resolve within a few months after delivery. Women are three times more likely than men to develop the condition, which may be caused by having a smaller carpal tunnel than men in general.
Certain occupations, such as assembly line workers, seamstresses, and hair stylists, may have a higher risk associated with developing carpal tunnel syndrome. Any activity requiring prolonged repetitive use of the arms, wrists, and hands have a significant increased incidence of the developing symptoms.
What Tests Help Diagnose Carpal Tunnel Syndrome?
Two useful clinical tests for diagnosing carpal tunnel syndrome are the Tinel and Phalen maneuvers. Tingling sensations in the fingers caused by tapping on the palm side of the wrist is a positive Tinel test, whereas reproduction of symptoms by fully flexing the wrist with the elbows in full extension is a positive Phalen test (Dr. Phalen created this maneuver many years ago when he was a hand surgeon at The Cleveland Clinic).
If needed, an electromyogram and nerve conduction studies are done to document the extent of nerve damage. An electromyogram is a test that measures the electrical activity in your nerves and muscles. Nerve conduction studies measure the ability of specific nerves to transmit electrical impulses or messages.
These tests, however, may not become positive until there is significant nerve damage. In addition, the severity of a person's symptoms is often not correlated with the findings of a nerve conduction study.