Carpal Tunnel Syndrome Part 1: Wrist Anatomy

By: CoordinatedHealthTV

- Carpal tunnel syndrome is a very common problem that causes numbness and tingling throughout your hand and fingers. This condition is often associated with occupations that require repetitive use of your hands and wrists, like typing, sewing, or assembly work. Now, while repetitive job movements are one cause of carpal tunnel syndrome, many people develop this condition regardless of the type of work they do. Your carpal tunnel is an opening formed by the carpal bones of your wrist on the one side and a ligament on the other. And passing through the tunnel is your median nerve.

It's this nerve that gives sensation to your thumb, index, long, and half of your ring finger. It also helps to control movements of your thumb. In addition to your median nerve, your flexor tendons pass through that carpal tunnel. These are the tendons that are responsible for movement of your fingers, thumb, and hand, like when you grasp an object. Your flexor tendons are surrounded by a slippery covering allowing the tendons to glide smoothly. The carpal tunnel can't expand. So any problems that cause abnormal pressure in the tunnel can produce carpal tunnel syndrome.

Abnormal pressure is caused by making the tunnel smaller or by increasing the stuff that's in the tunnel while the tunnel stays the same size, or an increase in the pressure itself within the carpal tunnel, which in turn reduces the blood flow to the nerve and causes a loss in nerve function. Today we're going to talk about the anatomy or parts list of your wrist and how it contributes to developing numbness and tingling, what activities you may be doing that increase your risk of developing carpal tunnel, what your symptoms feel like and how we evaluate a carpal tunnel syndrome, what are the latest treatment options for relieving your symptoms, what you can do right now to prevent or minimize your risk of developing carpal tunnel syndrome. Let's look at the parts list.

Well, first of all, there's this electric cable called the median nerve that runs from your neck down the middle of your arm, has to go through the wrist and into your hand because it needs to innervate or produce sensation for your thumb, your second, third, and part of your fourth fingers. So here comes this nerve that's coming down your arm and it's on its way to the hand. In order to get to the hand it runs through a little tunnel that sits right here at the wrist. So here is the tunnel. I'm going to just draw it as a little tube. This is the top of the tube.

Carpal Tunnel Syndrome Part 1: Wrist Anatomy

And this is the entrance to the tube. And this is the exit of the tube. So here comes the nerve.

It goes through the tunnel. It comes out the other side. And then it splits into branches. There's a cable that goes to the thumb. There's a cable that goes to the second finger. There's a cable that goes to your third finger. And there's a cable that goes to the inner side of your fourth finger. The problem develops when this cable gets pinched in this tunnel.

One of the most common ways for it to get pinched and inflammed is when the tunnel gets thick and the room in the tunnel is reduced. So let's take that tunnel now and draw it here and show you what I mean. Here's the tunnel.

Here's the cable that is the median nerve going through the tunnel. That's a normal tunnel. When the tunnel thickens, it gets thick and it gets swollen, it looks something like this. Swollen tunnel. And the hole through the tunnel gets smaller like this.

As a result, the nerve that's coming through the tunnel doesn't have much room. And as a result it gets pinched, irritated, and itself often swollen. This causes pain and the numbness in your fingers. When we do a carpal tunnel release, what we do is simply open the top of this tunnel.

As we open it, it's in so much tension that it just splits apart allowing the pressure to decrease on the nerve. In other words, it looks something like this. So we've made a split on top of the tunnel like this. And as a result of that, one end splits up this way. The other end splits down this way. And the nerve inside the tunnel that's been under pressure, painful and angry, now no longer has any pressure on it.

And you go from having a lot of pain to having much less and no pain.

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