Carpal tunnel syndrome article series: An introduction

Written by: Miss Samantha Tross
Published: | Updated: 22/09/2021
Edited by: Karolyn Judge

When the median nerve, a major nerve in our arm and wrist, is compressed, it can cause discomfort and disrupt everyday routines due to the symptoms it causes. More seriously, it can lead to permanent nerve damage if it goes untreated.

 

Renowned consultant orthopaedic surgeon Miss Samantha Tross speaks to Top Doctors for a three-part series about this common and sometimes debilitating, yet treatable, condition. She goes into expert detail about just what carpal tunnel syndrome is and its symptoms in the following article.

 

Close up of a hand with fingers outstretched, under a soft spotlight

 

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition in which the median nerve in the wrist is compressed within the carpal tunnel. The carpal tunnel is formed by the carpal bones below and the flexor sheath above. Passing through the tunnel are the flexor tendons, i.e., the tendons that cause your fingers to bend as well as the median nerve. The median nerve supplies your thumb, index, middle and radial half (the thumb half) of the ring finger. Hence compression of the nerve causes symptoms in one, some or all of these digits.

 

 

What are the symptoms of carpal tunnel syndrome?

The symptoms are:

  • Pain

 

  • Burning

 

  • Tingling, numbness and then ultimately, weakness

 

The above symptoms can be experienced in the fingers or wrist. The pain can also radiate into the forearm and occasionally into the arm. At an advanced stage, there may be weakness of the fingers and so you may find it difficult to do tasks such as closing buttons, opening jars, etcetera.

 

 

What causes carpal tunnel syndrome?

Anything that reduces the space around the nerve in the carpal tunnel, may lead to carpal tunnel syndrome. For example, if there's encroachment of the carpal bones leading to reduction of space from below, such as arthritis or malalignment of the bones due to a fracture or a previous injury, like a joint dislocation, all can lead to carpal tunnel syndrome.

 

Another possible cause is inflammation of the flexor tendons that pass through the tunnel with the medial nerve. Inflammation leads to swelling of the tendons and/or their sheath and is associated with conditions such as rheumatoid arthritis or any inflammatory condition.

 

If there's increased fluid in the tunnel, which can happen during conditions such as pregnancy where you get fluid retention, this leads to pressure on nerve and hence possible carpal tunnel syndrome.

 

If you have any kind of chronic disease, you can have a deposition of substance called amyloid within the carpal tunnel, which can lead to the syndrome. If you have extra fat in there, (we have fat all around the body and fat can also exist in the tunnel), this can lead to carpal tunnel syndrome.

 

Activities that involve persistent wrist flexion like typing without adequate wrist supports, lead to a reduction in the carpal tunnel space and can also lead to carpal tunnel syndrome.

 

 

To find out more about carpal tunnel syndrome, you can read Miss Tross’ articles about treatment and diagnosis in part two and surgery in part three.

 

Considering getting treatment for carpal tunnel syndrome or other orthopaedic conditions? Visit Miss Tross’ Top Doctors profile to make an appointment, here.

By Miss Samantha Tross
Orthopaedic surgery

Miss Samantha Tross is a renowned consultant orthopaedic surgeon practising at Bupa Cromwell Hospital and The Clementine Churchill Hospital. Miss Tross specialises in conditions affecting the knee and hip, robotic surgery and also trauma management. She also treats carpal tunnel syndrome.

Miss Tross is the lead orthopaedic surgeon at Ealing Hospital. She is also a part of Kensington Orthopaedics, which supports a multidisciplinary approach to her patient care. Miss Tross became an orthopaedic consultant in 2005 and was the first female of Afro-Caribbean descent in the UK to do so. In 2018, she also became the first woman in Europe to perform Mako robotic hip surgery.

She was born in Guyana, South America before moving to England aged 11. Miss Tross graduated from University College London in 1992. Much of her surgical training was on the Royal London rotation and higher surgical training on King’s College Hospitals and Guys & St. Thomas rotation. Miss Tross undertook fellowships in Toronto and Sydney.

Besides her clinical work, Miss Tross is an educational supervisor, faculty group leader and Director of Core Surgical training for her hospital. She oversees the training of junior doctors in her Trust. Miss Tross is an Examiner for Imperial Medical School exams, Associate Editor of the Journal of Medical Case Reports and the recipient of a Black British Business STEM Award.

Miss Tross regularly presents at international orthopaedic conferences and is also an associate professor in orthopaedics at the University of the Caribbean.

Miss Tross has been profiled in an educational series by Verna Wilkins, and features as part of the national curriculum for schools. Miss Tross has been included in the Black Powerlist of 100 most Influential Black Britons since 2009. In 2013 she was also named in Tatlers 100 most Influential doctors in the UK. Miss Tross was featured in the BMJ Careers in 2018 and the Stylist and Metro magazine in 2019. She was also awarded the WINTRADE Award for Women in the Public Sector and was the keynote speaker for the Mayor’s black history month event at City Hall.
 

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