The median nerve is a nerve in the upper extremity to provide sensation to your thumb, index finger, middle finger, and ring finger. It also provides motor function, meaning your ability to move and have strength in your hand. So it has motor function as well as sensory function in the hand. We're all different anatomically. We all have slight differences in our anatomy and some patients' anatomy is such that they're at an increased risk for developing carpal tunnel syndrome. For instance, they may just have a smaller space available for the median nerve, so they develop carpal tunnel syndrome more easily than someone else might.
Carpal tunnel syndrome is a compression phenomenon of the median nerve in the palm. Arthritis is a much more general term. "Arth" meaning joint. "Itis" meaning inflammation. What arthritis is, is it's inflammation of a joint and that can be any joint in your body. They are very distinct entities. Patients with arthritis certainly can have carpal tunnel syndrome and vice versa, but generally arthritis will present with pain and stiffness. Carpal tunnel syndrome presents with numbness and tingling in the fingers.
Carpal tunnel syndrome is a nerve compression that affects patients in predictable ways. The nerve involved in carpal tunnel syndrome is called the median nerve. It's one of the three main nerves in the upper extremity. It provides feeling to the thumb index, middle and ring finger or this side of the hand, and it also provides motor input to the thumb, which makes it a very important nerve. Patients with carpal tunnel syndrome experience symptoms because that nerve becomes compressed in the wrist as it travels through a very tight space called the carpal tunnel. Initially, patients begin to experience numbness as the sensory portion of that nerve is affected. As the condition progresses, which is its natural history, eventually they began to experience pain and then weakness as the motor portion of the nerve becomes affected. At that point, it starts to affect people functionally and they start to seek medical attention.
If a patient has neck problems, it cannot cause carpal tunnel because carpal tunnel is a disorder of the median nerve at the palm. That being said, it is possible for a patient to have what's called a double crush phenomenon where they can have numbness and tingling in their hand and it can be both as a result of compression of a nerve in the neck as well as compression of the nerve in the palm. So that's called a double crush phenomenon because they have the two nerves being compressed in two different areas.
People often ask how common is carpal tunnel syndrome? In fact, for hand surgeons, it's one of the most common conditions we treat. It actually affects approximately 5% of the overall population. However, when carpal tunnel syndrome is the result of an underlying medical condition such as diabetes, hypothyroidism, or inflammatory arthritis, that incidence can become much, much higher than the baseline 5% it's a very, very common condition.
Carpal tunnel syndrome is an extremely common condition that affects millions of people every day. It can be troublesome, waking up at night with a numb hand, experiencing pain and weakness during activities that would otherwise be normal. You should rest assured that carpal tunnel syndrome is treatable and that there is a way to cure the condition entirely. Treatment may be simple modification of your behaviors. It may be wearing a wrist splint at night to prevent flexion and therefore numbness of the hand while you sleep, or it may involve medical treatment, a steroid injection to shrink swelling around the nerve, medication to treat your pain, or when the condition is progressive and nerve conduction studies show that there's some risk of damage to the nerve, surgical treatment can and usually does cure carpal tunnel syndrome. Talk to your doctor about your symptoms and seek out medical attention when you feel it's necessary.
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