Carpal tunnel syndrome is a common condition that causes pain and numbness in the hand and wrist. It occurs when the median nerve, which runs from the forearm into the hand, becomes compressed. The carpal tunnel is a narrow passageway in the wrist surrounded by bones and ligaments. This passageway is where the median nerve and other tendons pass through. When the median nerve is compressed, it can cause pain, tingling, and numbness in the thumb, index, middle and ring fingers.
Carpal tunnel syndrome is more likely to occur in women than men, and is usually seen in people over the age of 40. It can be caused by a variety of factors, including repetitive motions of the hands and wrists, such as typing on a keyboard or using a mouse for extended periods of time. It can also be caused by certain medical conditions, such as diabetes, arthritis, and thyroid problems.
The most common symptom of carpal tunnel syndrome is numbness and tingling in the first 4 fingers. If the small finger is involved, consider evaluation of the Cubital Tunnel (See the Cubital Tunnel Blog). Other symptoms include a decrease in grip strength, difficulty in performing fine motor tasks, and a burning sensation in the palm of the hand. If left untreated, carpal tunnel syndrome can cause permanent nerve damage. At times, this damage is not reversible with surgery.
The diagnosis is often made by the history and physical examination. At times, it may be necessary to perform a nerve conduction study with electromyogram to determine if there are overlapping diagnoses like cervical radiculitis or peripheral neuropathy.
What are the treatments of carpal tunnel syndrome?
The primary treatment for carpal tunnel syndrome is the use of splints or braces that can be worn during activities that involve repetitive motions of the hands. These splints or braces keep the wrist in a neutral position and help to reduce the pressure on the median nerve. Wearing these “cock-up” wrist splints at night can help to calm the nerve down and avoid night symptoms.
Other treatments may include anti-inflammatory medications, such as ibuprofen or naproxen, to reduce swelling and pain. Corticosteroid injections may also be used to reduce inflammation and swelling.
In more severe cases, surgery may be necessary to reduce pressure on the median nerve. During the surgery, a small portion of the ligament that is compressing the median nerve is cut. This helps to reduce the pressure and improve symptoms. Surgery is often the most reliable way to treat carpal tunnel syndrome. There are risks that will be discussed, although complications are relatively rare if your surgeon’s directions are followed. Carpal tunnel syndrome can be a painful and debilitating condition. If you are experiencing any of the symptoms of carpal tunnel syndrome, it is important to see your doctor for a proper diagnosis and treatment plan. Nerve studies can be helpful but are not always needed. With the right treatment, you can reduce your symptoms and get back to enjoying life.
Dr. Prisk performs carpal tunnel surgery through a small open incision. Recovery is relatively quick with immediate use of the fingers and early therapy. When in Doubt, Check it Out! Call P.O.W. to discuss treatments at 412-525-7692.
