What causes carpal tunnel syndrome?

Written in association with: Miss Kerstin Oestreich
Published: | Updated: 01/08/2024
Edited by: Conor Lynch

Carpal tunnel syndrome (CTS) is a common condition that affects the hand and arm, causing pain, numbness, and tingling. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (excluding the little finger) as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.

 

On hand to provide more expert detail regarding the condition is Miss Kerstin Oestreich, a leading plastic, cosmetic, and hand surgeon. 

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is often caused by a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel. These factors may include congenital predispositions (the carpal tunnel is smaller in some people), repetitive hand movements, wrist anatomy, pregnancy, and conditions such as diabetes, thyroid dysfunction, and rheumatoid arthritis. Repetitive activities, particularly those involving the use of vibrating tools, prolonged use of a computer keyboard, or other repetitive hand movements, can contribute significantly to CTS.

 

What are the symptoms of carpal tunnel syndrome?

Symptoms typically start gradually with frequent burning, tingling, or itching numbness in the palm of the hand and fingers, especially the thumb and the index and middle fingers. Some people experience their fingers feeling useless and swollen even when no swelling is evident.

 

Symptoms of carpal tunnel syndrome often first appear in one or both hands during the night, as many people sleep with flexed wrists. A person with CTS may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, they may feel tingling during the day, decreased grip strength, and difficulty performing tasks like buttoning clothes.

 

How is carpal tunnel syndrome treated?

Early diagnosis and treatment are crucial to prevent permanent damage to the median nerve. Initial treatments typically involve resting the affected hand and wrist, avoiding activities that may worsen symptoms, and immobilising the wrist in a splint to prevent further damage from twisting or bending. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and inflammation.

 

In more severe cases, corticosteroid injections or surgery might be required. Surgery involves cutting the ligament that is pressing on the median nerve, which can relieve the pressure and alleviate symptoms.

 

Preventive measures include taking frequent breaks from repetitive tasks, stretching exercises, and ensuring proper ergonomic setups at workstations. Understanding and mitigating the risk factors for CTS can significantly improve one's quality of life and prevent the progression of the syndrome.

By Miss Kerstin Oestreich
Plastic surgery

Miss Kerstin Oestreich is a highly respected and internationally trained consultant plastic, cosmetic and hand surgeon based in Birmingham. She is renowned for her expertise in cosmetic breast surgery as well as labiaplasty and tummy tuck procedures. Additional to plastic and cosmetic surgery, Miss Oestreich also specialises in hand and wrist surgery and treats both adults and children.

Miss Oestreich qualified in medicine in 1995 in Heidelberg-Mannheim, Germany before undertaking further surgical training in Mannheim-Ludwigshafen, Germany, Dublin, Ireland and Singapore. She qualified as a specialist plastic surgeon in 2006 while training at one of Europe’s largest plastic surgery units in Ludwigshafen, Germany. Following this, she completed a hand surgery fellowship as well as specialist training in wrist arthroscopy at a number of locations across Europe. Miss Oestreich has attended numerous courses and meetings specialising in cosmteic hand surgery. Miss Oestreich was appointed as a consultant plastic and hand surgeon in 2007 at Salisbury’s NHS Foundation Trust, which has one of the UK’s largest plastic surgery departments. She is an honorary consultant plastic and hand surgeon at Derby’s renowned Pulvertaft Hand Centre. From 2014 until recently, Miss Oestreich held a position as a plastic consultant in the prestigious Birmingham Children's Hospital, building a comprehensive paediatric wrist service. She has now turned her focus on her private practice in the west Midlands

Miss Oestreich sees private patients at the renowned Kat & Co clinic in Birmingham, Spire Little Aston Hospital in Sutton Coldfield and Spire Parkway Hospital in Solihull, as well as Priory Hospital in Birmingham and the Westbourne Centre in Birmingham.

Additional to her walth of clinical training and experience, Miss Oestreich has also been awarded a degree in European healthcare leadership from INSEAD, France and a Master’s degree in healthcare management. In 2009, she was presented with a leadership award from Health Foundation London and has been instrumental in implementing changes to healthcare systems at a national level. She regularly presents and lectures on her areas of expertise at meetings around the world and has authored numerous publications, which appear in peer-reviewed journals, as well as several book chapters.

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