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Wrist Carpal Tunnel Syndrome Carpal Tunnel syndrome (CTS) is a collection of symptoms such as tingling, numbness, weakness and pain in the fingers and hand mostly. It is caused by pressure on the Median nerve, which courses through a tight tunnel between the tiny wrist bones and its overlying ligament. Blood vessels and tendons also pass through it. The Median nerve provides function to the thumb and sensation to the index, long and part of the ring fingers. Causative activities include: overuse of the hands/wrists (computer work, gardening...), direct pressure on the wrist, pregnancy, obesity and smoking. Other medical conditions can predispose towards CTS: diabetes, Rheumatoid Arthritis, hypothyroidism etc.Treatment is always conservative initially. Relieving pressure on the Median nerve is critical. Modification of activity is usually necessary (discontinuing the activity, modifying the setup, bracing). A physical therapist can explain the importance of keeping the wrist in a neutral position(such as holding a pen), especially during repetetive activities. Various mobilization techniques and modalities may help. Surgery, as always, is the last resort and involves severing the ligament of the carpal tunnel to provide more room for the nerve. References: * J Hand Surg [Am]. 2006 Nov;31(9):1483-9 * Clin Evid. 2005 Dec;(14):1351-65
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