Carpal Tunnel Syndrome: Hand Pain and Numbness
With so much typing and scrolling, carpal tunnel is common. The symptoms, causes (including RA), and why early treatment protects the nerve.
Hand pain and numbness are two common reasons for a rheumatology consult. With so much typing on computers and smartphones, plus gaming, carpal tunnel syndrome is often high on the list.
Carpal tunnel syndrome can present as numbness or tingling, often in the first three fingers rather than the little finger, 'electric shocks' up the wrist and arm, difficulty with tasks like buttoning clothes, and trouble gripping or dropping objects. Symptoms may be intermittent at first, then become more persistent.
It is caused by compression or irritation of the median nerve as it travels from the forearm through a tunnel in the wrist. Persistent pressure can cause permanent nerve damage. Rheumatoid arthritis is often considered, because the lining of the surrounding tendons can press on the nerve. Other causes include wrist fracture, female sex, diabetes, certain breast-cancer medications, pregnancy, menopause, thyroid disorders, kidney disease, and occupations involving constant wrist flexion.
Prevention is key: take breaks from repetitive wrist movement and stretch the hands, position your keyboard around elbow height, make sure your mouse doesn't strain your wrist, and relax your grip. See a doctor early if you have symptoms.
Treatment options include a splint or brace to reduce pressure, physical and occupational therapy, anti-inflammatory medications or steroid injections, and, when needed, carpal tunnel release surgery to decompress the nerve.
Dr. Maggie Cadet, MD