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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

हाथ का सुन्न होना - संपूर्ण गाइड और इलाज

Hand Numbness & Wrist Pain - Complete Guide & Treatment

भाषा / Language:
हिंदी English
हिंदी
👥 3-6% लोग प्रभावित Population Affected
👩 3:1 महिला : पुरुष Women : Men
✅ 80% Conservative से ठीक Heal Without Surgery
⏰ 2-6 सप्ताह - Surgery Recovery Weeks - Surgery Recovery
🔬

Carpal Tunnel Syndrome क्या है?

What is Carpal Tunnel Syndrome?

सरल भाषा में: Carpal Tunnel Syndrome (CTS) कलाई में Median nerve के compression से होता है। Carpal tunnel एक narrow passage है जहाँ nerve फंस जाती है।

🎯 Key Facts!

Most common nerve compression! हाथ में सुन्नपन, झनझनाहट और दर्द। खासकर रात में worse। Women में 3x ज्यादा। Pregnancy, diabetes, computer work high risk!

✅ Normal Wrist

  • Median nerve free space
  • No pressure या compression
  • Full hand sensation
  • Strong grip
  • Pain-free movement

❌ Carpal Tunnel Syndrome

  • Median nerve compressed
  • Tunnel swollen/narrowed
  • Numbness in thumb-middle fingers
  • Night pain/tingling
  • Weak grip और clumsiness

🦴 Anatomy - कैसे होता है:

Carpal Tunnel: कलाई में narrow passage - bones + transverse carpal ligament से बनी

Median Nerve: Forearm से hand में जाती है - thumb, index, middle और आधी ring finger को sensation और movement देती

9 Flexor Tendons: Fingers move करने वाली - tunnel में nerve के साथ

Problem: Tunnel narrow या swollen → Median nerve पर pressure → Numbness + Tingling + Pain!

⚠️ Progressive: धीरे-धीरे worse होता। Early treatment जरूरी!

📊 Key Statistics:

3-6%आबादी
प्रभावित
3:1Female:Male
Ratio
40-60Years
Peak Age
50%Both hands
affected

⚠️ Common Misconceptions:

  • Myth: सिर्फ computer users को। Fact: कई कारण - pregnancy, diabetes, arthritis!
  • Myth: Wrist rest से ठीक होगा। Fact: Progressive condition - treatment जरूरी।
  • Myth: Surgery ही option है। Fact: 80% conservative treatment से manage।
  • Myth: Permanent cure नहीं। Fact: Surgery 90-95% successful!

Simply: Carpal Tunnel Syndrome (CTS) is compression of median nerve in wrist. Carpal tunnel is narrow passage where nerve gets trapped.

🎯 Key Facts!

Most common nerve compression! Hand numbness, tingling, pain. Especially worse at night. 3x more in women. Pregnancy, diabetes, computer work high risk!

✅ Normal

  • Median nerve free
  • No compression
  • Full sensation
  • Strong grip
  • Pain-free

❌ CTS

  • Nerve compressed
  • Tunnel narrowed
  • Thumb-middle fingers numb
  • Night pain
  • Weak grip

📊 Key Stats:

3-6%Population
3:1Female:Male
50%Bilateral
🩺

लक्षण कैसे पहचानें?

Symptoms & Diagnosis

🚨 Main Symptoms: हाथ का सुन्न होना + झनझनाहट!

खासकर thumb, index, middle और आधी ring finger में। रात में ज्यादा worse। हाथ हिलाने से relief।

🔴 Classic Symptoms:

🖐️

Numbness & Tingling

Classic sign! Thumb + Index + Middle + half Ring finger। NOT little finger (ulnar nerve)। Intermittent initially, then constant। "Pins and needles" feeling।

🌙

Night Symptoms

Very characteristic! रात में जागते हैं numbness/pain से। Wrist naturally flexed during sleep। हाथ हिलाने से ("flick sign") relief। Severe में पूरी रात disturbed।

😣

Pain & Burning

Wrist और palm में। Forearm तक radiate। Sometimes shoulder तक। Burning या shooting sensation। Prolonged hand use से worse।

🤏

Weak Grip

Objects गिर जाते हैं। Buttoning shirts मुश्किल। Keys turn नहीं हो पाती। Thenar muscle wasting (thumb base muscle) advanced में। Thumb pinch weak।

❄️

Cold Sensitivity

Cold weather में worse। Hand feels cold। Poor circulation feeling। Gloves से temporary relief।

🚗

Activity-Triggered

Driving (steering grip)। Phone holding। Reading (book)। Typing। Cooking। Any prolonged wrist flexion या extension।

🔍 Clinical Tests - Doctor ये करते हैं:

🙏

Phalen's Test

Most sensitive - 75% accuracy! दोनों wrists को flex करके 60 seconds। Hands को "prayer position" reverse में। अगर numbness/tingling = Positive। 1 minute के अंदर symptoms reproduce।

👆

Tinel's Sign

Wrist के अंदर (median nerve पर) tap करते हैं। अगर fingers में shooting sensation = Positive। 50% sensitivity। Quick screening test।

✊

Grip & Pinch Strength

Dynamometer से measure। Affected hand weak। Thumb pinch test। Advanced CTS में significant weakness। Thenar muscle atrophy check।

⚡

Nerve Conduction Study (NCS)

Gold standard diagnosis! Electrical test। Nerve speed measure। Confirms diagnosis। Severity assess। Pre-surgery जरूरी। ₹2000-5000।

🎯

2-Point Discrimination

Fingertip sensation test। Normal: <6mm discrimination। CTS में reduced। Advanced nerve damage marker। Sensory deficit measurement।

📷

Imaging (कभी-कभी)

Usually नहीं! X-ray: Arthritis rule out। MRI: Rare - other pathology। Ultrasound: Median nerve swelling visualize। Research tool mainly।

🏠 घर पर Self-Test:

Phalen's Test (Modified): दोनों wrists को maximum flex करें (backs of hands together)। 1 minute hold। अगर fingers में numbness/tingling = Carpal Tunnel possibility!

Flick Sign: रात को numbness/tingling से जागते हैं? हाथ हिलाने से relief मिलता? = Very suggestive!

Symptom Distribution: Thumb + Index + Middle + half Ring affected? Little finger NOT affected? = Median nerve pattern!

⚠️ Important: Self-test सिर्फ indication। NCS diagnosis confirm करती है!

⚠️ Severity Grading:

  • Mild: Intermittent numbness। Night symptoms only। No weakness। Quick recovery।
  • Moderate: Frequent numbness। Day + night। Mild weakness। Longer recovery time।
  • Severe: Constant numbness। Significant weakness। Thenar atrophy। Limited recovery potential। Surgery needed!

🚨 Red Flags - तुरंत Doctor:

  • Thenar muscle wasting visible - thumb base flat
  • Constant numbness - no relief
  • Significant hand weakness - objects dropping
  • Symptoms बिगड़ते जा रहे rapidly
  • Both hands severely affected
  • Pain unbearable - sleep impossible

⚠️ Warning: Severe CTS में permanent nerve damage! Early treatment critical!

🚨 Main: Hand Numbness + Tingling!

Especially thumb, index, middle & half ring finger. Worse at night. Relief with shaking hand.

🔴 Classic Symptoms:

🖐️

Numbness & Tingling

Classic! Thumb + Index + Middle + half Ring. NOT little finger. Intermittent → constant. "Pins and needles".

🌙

Night Symptoms

Very characteristic! Wake up with numbness/pain. Wrist flexed during sleep. "Flick sign" relief. Severe = disturbed sleep.

🤏

Weak Grip

Objects drop. Difficulty buttoning. Can't turn keys. Thenar muscle wasting (advanced). Weak thumb pinch.

🚗

Activity-Triggered

Driving, phone holding, reading, typing, cooking. Any prolonged wrist flexion/extension.

🔍 Clinical Tests:

🙏

Phalen's Test

Most sensitive - 75%! Flex both wrists 60 seconds (reverse prayer). Numbness/tingling = Positive. Reproduces symptoms within 1 min.

⚡

NCS

Gold standard! Electrical test. Nerve speed measurement. Confirms diagnosis + severity. Pre-surgery essential. ₹2000-5000.

🔍

कारण क्या हैं?

Causes & Risk Factors

⚡ Main Cause: Increased Pressure in Carpal Tunnel!

Tunnel narrow होना + Swelling → Median nerve पर pressure। Multiple factors contribute। Often combination of genetic + lifestyle।

🎯 Major Risk Factors:

👩

Female Gender

3x higher risk! छोटी carpal tunnel। Hormonal factors। Pregnancy और menopause। Age 40-60 peak। Estrogen fluctuations।

🤰

Pregnancy

Very common - 30-50%! Fluid retention। Swelling in tunnel। 3rd trimester worst। Usually resolves post-delivery। Temporary condition mostly।

🩺

Diabetes

2x risk! Nerve damage susceptibility। Poor blood flow। Longer duration = higher risk। Metabolic changes। Neuropathy overlap।

🦴

Rheumatoid Arthritis

Inflammation in tunnel। Tenosynovitis (tendon sheath swelling)। Synovial tissue thickening। Autoimmune process। Progressive worsening।

⚡ Main Cause: Increased Carpal Tunnel Pressure!

Tunnel narrowing + Swelling → Median nerve compression। Multiple factors. Often genetic + lifestyle combination।

🎯 Major Risk Factors:

👩

Female

3x higher risk! Smaller carpal tunnel. Hormonal factors. Pregnancy & menopause. Age 40-60 peak.

🤰

Pregnancy

Very common - 30-50%! Fluid retention. Swelling. 3rd trimester worst. Usually resolves post-delivery.

🩺

Diabetes

2x risk! Nerve susceptibility. Poor blood flow. Metabolic changes. Neuropathy overlap.

💊

इलाज कैसे होता है?

Treatment Options

✅ Treatment Success Rates!

Conservative (Mild-Moderate): 80% improvement! Splinting, exercises, lifestyle। Surgery (Severe): 90-95% success! Simple procedure, quick recovery।

🏆 Treatment Approach by Severity:

Mild CTS: Conservative (3-6 months)

🌙

Wrist Splinting

#1 most effective! Neutral wrist splint। रात में जरूरी - prevents flexion। Day में optional। 4-6 weeks। ₹500-2000। 70-80% improve! Stops nerve irritation।

💊

NSAIDs

Ibuprofen या Naproxen। Limited benefit - only for associated inflammation। 2-3 weeks trial। Not proven highly effective। Better for acute flare-ups।

😴

Activity Modification

Avoid prolonged wrist flexion। Take breaks (every 30 min)। Alternate tasks। Reduce forceful gripping। Job modifications if possible।

🏃

Physical Therapy

Nerve gliding exercises। Tendon gliding। Wrist strengthening। Ergonomic training। 6-8 sessions। ₹500-1000/session।

Moderate CTS: Add Injections

💉

Corticosteroid Injection

Very effective - 75% improve! Into carpal tunnel। Relief 3-6 months। Can repeat × 2-3। ₹2000-5000। Caution: Temporary। May delay surgery। Risk: Nerve damage if misplaced।

Severe CTS: Surgery (Gold Standard)

🔪

Carpal Tunnel Release

Simple, highly successful! Cut transverse carpal ligament। Relieves pressure। 15-30 min procedure। Local या regional anesthesia। Same day discharge। 90-95% success!

🩹

Open vs Endoscopic

Open: 2-3 inch incision। Direct visualization। Classic। Endoscopic: 1-2 small cuts। Camera guided। Faster return। Both equally effective। Surgeon preference।

⏰ Recovery Timeline:

Day 1-7: Bandage। Minimal use। Elevate। Pain medication।

Week 2: Stitches out। Light activities। Gentle exercises।

Week 4-6: Most activities। Driving OK। Return to desk work।

Week 8-12: Heavy work। Full strength। Complete healing।

Numbness: Immediate relief! Strength: 2-3 months full। Scar: Fades 6-12 months।

💰 Treatment Costs:

Wrist Splint: ₹500-2000

NSAIDs: ₹300-500/month

Physical Therapy: ₹3000-8000 (6-8 sessions)

Corticosteroid Injection: ₹2000-5000

NCS Test: ₹2000-5000

Surgery (CTR): ₹30,000-80,000 (private)

Surgery (Govt): ₹5,000-15,000

✅ Success Rates!

Conservative (Mild): 80% improve! Splinting, exercises. Surgery (Severe): 90-95% success! Simple, quick recovery.

🏆 By Severity:

Mild: Conservative (3-6 months)

🌙

Wrist Splint

#1 most effective! Neutral wrist. Night essential. 4-6 weeks. ₹500-2000. 70-80% improve!

💊

NSAIDs

Ibuprofen/Naproxen. Limited benefit - only inflammation. 2-3 weeks trial. Better for flare-ups.

🏃

Physical Therapy

Nerve gliding. Tendon gliding. Strengthening. Ergonomics. 6-8 sessions. ₹500-1000/session.

Severe: Surgery

🔪

Carpal Tunnel Release

Simple, highly successful! Cut ligament. Relieves pressure. 15-30 min. Local anesthesia. Same day. 90-95% success!

⏰ Recovery:

Week 1-2: Light use. Week 4-6: Most activities. Week 8-12: Full strength. Numbness: Immediate relief!

❓

अक्सर पूछे जाने वाले सवाल (FAQ)

Frequently Asked Questions (FAQ)

सभी / All
Basics
Symptoms
Treatment
Prevention
❓

Carpal Tunnel Syndrome क्या है? / What is it?

▼

Median nerve का compression कलाई में। Carpal tunnel narrow passage। Pressure बढ़ने से numbness, tingling, pain। Most common nerve compression! Age 40-60 peak। Women 3x more। 3-6% population। Usually both hands।

🖐️

Main लक्षण? / Main symptoms?

▼

Numbness + tingling thumb, index, middle, आधी ring finger में! NOT little finger (important!)। Night symptoms - जागते हैं। हाथ हिलाने से relief ("flick sign")। Weak grip। Objects drop। Burning pain। Progressive worsening।

💊

इलाज? / Treatment options?

▼

Severity पर depend! Mild: Night splint + exercises (80% improve)। Moderate: Splint + injection (75% relief)। Severe: Surgery - Carpal Tunnel Release (90-95% success!)। Quick procedure, minimal complications। Numbness immediate relief!

🌙

रात में क्यों worse? / Why worse at night?

▼

Sleep में wrist naturally flexed होती! Flexion से tunnel pressure बढ़ता। Nerve compression increase। Plus - daytime fluid accumulates। Gravity effect lost। Classic CTS sign! Splint prevents flexion = symptoms reduce।

👩

Women में क्यों ज्यादा? / Why more in women?

▼

3:1 ratio - women:men! Reasons: (1) Smaller carpal tunnel। (2) Hormonal - pregnancy, menopause। (3) Fluid retention tendency। (4) Autoimmune conditions more common। (5) Anatomical factors। Peak age 40-60। Pregnancy में 30-50% develop।

🌙

Night splint कैसे काम करता? / How splint works?

▼

#1 non-surgical treatment - 70-80% improve! Keeps wrist neutral position - prevents flexion। Reduces tunnel pressure। रात में जरूरी - prevents night symptoms। Wear 4-6 weeks consistent। ₹500-2000। Can wear day भी if needed। Simple, very effective!

🔪

Surgery कब जरूरी? / When surgery needed?

▼

Severe cases! Indications: (1) Thenar atrophy - thumb muscle wasting। (2) Constant numbness। (3) Failed conservative 3-6 months। (4) Severe NCS। (5) Bilateral severe। Don't delay - permanent nerve damage risk! Surgery simple, safe, 90-95% successful।

⏰

Surgery recovery time? / सर्जरी के बाद?

▼

Quick recovery! Week 1-2: Light use। Stitches out week 2। Week 4-6: Most activities, driving। Week 8-12: Full strength। Numbness: Immediate relief! Strength: 2-3 months fully returns। Simple procedure - 15-30 min। Local anesthesia। Same day discharge। ₹30,000-80,000।

💻

Computer work से होता है? / Caused by computers?

▼

Link weak - evidence inconclusive! Commonly blamed but not proven causal। Real causes: Genetics, female gender, pregnancy, diabetes, arthritis। Computer work may worsen existing CTS। Ergonomics important but not prevention। Overreported connection। Multiple factors usually।

⚡

NCS test क्या है? / What is NCS?

▼

Nerve Conduction Study - Gold standard diagnosis! Electrical test। Nerve speed measure। Confirms CTS + assesses severity। Mild discomfort (electric shocks)। 20-30 min। ₹2000-5000। Pre-surgery essential! Objective measurement। Rules out other nerve problems।

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