Some athletes have found that their performance of a favorite sport that requires the use of their hands is affected by a condition called carpal tunnel syndrome. Carpal tunnel syndrome (CTS) is a common condition that affects the hand and the wrist. The carpal tunnel is a passageway at the base of the palm side of the hand made up of the tendons that flex the fingers and the thumb, the carpal bones (wrist bones), a lateral carpal ligament and the median nerve. The median nerve provides sensation to the thumb, index and middle fingers, and part of the ring finger. The nerve also provides power to the thumb muscles. Compression of the median nerve within the carpal tunnel and against the carpal ligament can cause pain and numbness in the hand.

Signs and Symptoms:
Numbness and tingling in the fingers at night are often the early signs of possible CTS. Other signs are burning pain in the hand, wrist, and fingers; weakened grip involving the thumb; and a feeling that the hand is asleep.

Causes:
CTS is a disorder that is usually caused by the physical demands that we place on our hands. The leading cause is repetitive hand movement from such activities as typing, using compressed air tools, or working with vibrating tools. Performing these repetitive activities on a prolonged basis will lead to inflammation and swelling around the flexor finger tendons. Sports like bicycling, canoeing, and golfing that require the wrist to be kept in a static position may also contribute to CTS.

Treatment:
CTS is often diagnosed by using a simple test. The individual rests his elbows on a table and lets his wrists fall freely forward over the edge of the table. Individuals with CTS feel tingling in their fingers within one to two minutes. A median nerve conduction study can help confirm that CTS exists.

Once CTS is diagnosed, treatment begins with wearing a splint to restrict the wrist motion that aggravates the condition and to allow the inflammation and swelling within the carpal tunnel to subside. Also, oral anti-inflammatory drugs can be taken to help to decrease the swelling around the median nerve.

Learning how to properly use the hands and wrists is a important treatment and prevention goal. Keep your wrists straight when working with tools. Rest the wrists lightly on a pad in front of the keyboard when typing. Take breaks or change job tasks to avoid using the hand and wrist in one position for extended periods.

Surgery is only recommended when the individual experiences continued decreased sensation, grip weakness, or intolerable discomfort. The most common surgical approach is to divide the carpal ligament that covers the carpal tunnel. The surgical goal is to decrease the pressure on the median nerve by enlarging the carpal tunnel. CTS surgery is an outpatient procedure done under local anesthesia. After a short recovery period, the hand and the wrist undergo a progressive exercise program. While the recovery process will vary, most individuals return to normal hand activities within six weeks.