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Carpal Tunnel Syndrome
&
Tarsal Tunnel Syndrome
What is carpal tunnel syndrome?
Carpus is a word derived from the Greek word "karpos"
which means "wrist." The wrist is surrounded by a band
of fibrous tissue which normally functions as a support for the
joint. The tight space between this fibrous band and the wrist
bone is called the carpal tunnel. The median nerve passes through
the carpal tunnel to reach the thumb, index, and middle fingers
of the hand. Any condition that causes swelling or a change in
position of the tissue within the carpal tunnel can squeeze and
irritate the median nerve. Irritation of the median nerve causes
tingling and numbness of the thumb, index, and the middle fingers,
a condition known as "carpal tunnel syndrome." What is tarsal tunnel syndrome?
Anatomy similar to that of the wrist and hand exists
in the ankle and foot. Tarsal is a word from Latin which means
ankle. When the sensory nerve that passes through the tarsal tunnel
is irritated, numbness and tingling of the foot and toes can be
felt. This condition is referred to as "tarsal tunnel
syndrome." It is an analogous to, but far less common
than, carpal tunnel syndrome.
What conditions and diseases cause carpal tunnel
syndrome?
For most patients, the cause of their carpal tunnel
syndrome is unknown. Any condition that exerts pressure on the
median nerve can cause carpal tunnel syndrome. Common conditions
that can lead to carpal tunnel syndrome include obesity, pregnancy,
hypothyroidism, arthritis, diabetes, and trauma. Tendon inflammation
resulting from repetitive work, such as uninterrupted typing, can also
cause carpal tunnel symptoms. Carpal tunnel syndrome from repetitive
maneuvers has been referred to as one of the repetitive stress
injuries. Some rare diseases can cause deposition
of abnormal substances in and around the carpal tunnel, leading
to nerve irritation. These diseases include amyloidosis, sarcoidosis,
multiple myeloma and leukemia.
How does a patient with carpal tunnel syndrome
feel?
Patients with carpal tunnel syndrome initially feel
numbness and tingling of the hand in the distribution of the median
nerve (the thumb, index, middle, and part of the fourth fingers).
These sensations are often more pronounced at night and can awaken
patients from sleep. The reason symptoms are worse at night may
be related to the flexed-wrist sleeping position and/or fluid
accumulating around the wrist and hand while lying flat.
As the disease progresses, patients can develop a
burning sensation, cramping and weakness of the hand. Decreased
grip strength can lead to frequent dropping of objects from the
hand. Occasionally, sharp shooting pains can be felt in the forearm.
Chronic carpal tunnel syndrome can also lead to wasting (atrophy)
of the hand muscles.
How is carpal tunnel syndrome diagnosed?
The diagnosis of carpal tunnel syndrome is suspected
based on the symptoms and distribution of the hand numbness.
Examination
of the neck, shoulder, elbow, pulses, and reflexes can be performed
to exclude other conditions that can mimic carpal tunnel syndrome.
The wrist can be examined for swelling, warmth, tenderness, deformity,
and discoloration. Sometimes tapping the front of the wrist can
reproduce tingling of the hand, and is referred to as Tinel's
sign of carpal tunnel syndrome. Symptoms can also at times be
reproduced by bending the wrist forward, and is referred to as
Phalen's maneuver.
 For more information, visit our
Carpal Tunnel Syndrome Forum
Last Editorial Review: 7/11/00
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