Common Causes

Carpal Tunnel Syndrome.

Ganglion.

Synovitis ? R.A. or Koch's

Less Common Causes

Extensor carpi ulnaris tenosynovitis (Frictional)

Inferior radio-ulnar joint and cartilage injury

Kienbock's disease (Avascular necrosis of the lunate)

Carpal instability

Referred pain from cervical spine pathology

Non-union of the scaphoid bone

Ganglion

• It is a small swelling most commonly seen on back of the wrist.
• It usually arises from outer covering of joints or tendons.
• Cause is usually unknown but may be attributed to occupation or repetitive injury.
• It is firm, smooth fluctuant and round.
• Usually associated with mild discomfort and weakness. Rarely painful.

Treatment : Complete, careful surgical removal.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition in which one gets burning sensation or feeling of pins and needles in the hand and the fingers. The person may feel clumsiness while working, may complain of inability to hold objects for a long time. Another common complaint is getting up in the middle of the night with burning in the affected hand, or getting up in the morning with stiff hand.

• It is due to compression of the median nerve at the wrist. The nerve gets pressed between the bones forming the wrist joint and deep transverse carpal ligament.
• It is approximately five times more common in women than in men.
• It is most common between 30-60 years.
• It is also common during and after pregnancy, in persons having poorly functioning thyroid gland, or those who suffer from diabetes.
• It may occur in patients with rheumatoid arthritis and rarely after wrist fracture.
• Also at risk are people using vibrating machinery and computers.

Symptoms of Carpal Tunnel Syndrome

Symptoms consist of altered sensations, burning and numbness of hand, weakness or clumsiness, relieved by exercise.

Diagnosis for Carpal Tunnel Syndrome

Diagnosis is proved by measuring electric conduction across the nerve and by Electromyography of muscles of hand.

Treatment for Carpal Tunnel Syndrome

Treatment consists of avoiding precipitating and aggravating factors, wearing a wrist support. In cases presenting late surgical release of the nerve ensures cure.