What is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway on the palm side of the wrist made up of bones and ligaments. The median nerve and a few tendons run from the forearm to the hand through the carpal tunnel. The median nerve controls some thumb movement and feeling in all fingers except the pinky.

Carpal tunnel syndrome occurs when the median nerve is pinched or compressed, and the condition is characterized by feelings of numbness, tingling, weakness or pain in the hand. The onset of symptoms is generally slow as patients are most likely to first experience discomfort during the night or when they first wake up. Symptoms tend to progressively worsen over time. They may also feel pain or tingling when holding objects or when driving.

Emily, a recent patient at South Florida Orthopaedics & Sports Medicine, experienced carpal tunnel syndrome in both of her hands. Based on her previous treatment experiences at the practice, she sought care from Check C. Kam, MD, FAAOS, a board-certified orthopaedic surgeon specializing in surgery of the upper extremities.

“I’ve had great results so far in everything I’ve done at South Florida,” she says.

When Emily found herself unable to perform her normal daily activities despite trying more conservative methods, Dr. Kam suggested surgery as the best treatment option for her.

“Emily’s symptoms were severe and refractory to splint treatment. After a long discussion about potential treatments, she elected to have a release,” Dr. Kam said.

Have you ever experienced a sense of tingling or numbness in your hand? This may be a sign of carpal tunnel syndrome, a nerve disorder that affects between 4 and 10 million Americans.

The carpal tunnel is a narrow passageway surrounded by bones and ligaments. It is responsible for protecting the tendons that allow the fingers to bend as well as the main nerve in the hand. The tunnel can be found on the palm side of the wrist

Repetitive movements and compression of this nerve can cause tingling, numbness, and hand weakness, known as carpal tunnel syndrome.

Common repetitive movements that can cause carpal tunnel syndrome include:

  • Driving
  • Typing
  • Holding a book
  • Any activity that requires holding something or bending the wrist for long periods of time.

A multitude of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, underlying health problems and even patterns of hand use.

Due to the spontaneous nature of the pain associated with carpal tunnel syndrome, many people do not seek medical help. However, it is important to seek treatment and rest your wrist as soon as you experience symptoms to avoid further damage to the wrist.

In more severe cases, carpal tunnel syndrome can cause chronic burning, numbness, and even loss of muscle mass in the palm. In these instances, particularly when untreated, individuals may experience hand weakness, loss of sensation and impaired use of the hand as a result of permanent nerve and muscle damage.

Fortunately, for most people who develop carpal tunnel syndrome, proper treatment can relieve the tingling and numbness and restore hand and wrist function.

What Are Treatments for Carpal Tunnel Syndrome?

When symptoms of carpal tunnel syndrome are first recognized, it is important to rest the hand and wrist and stop the activity that triggered the pain. For mild cases, at home remedies can be used to treat the wrist before scheduling to meet with a hand and wrist specialist. Common at home treatments include:

  • Icing the wrist
    • Use increments of 10 to 15 minutes every hour or two.
  • Taking nonsteroidal anti-inflammatory medication
    • This will reduce swelling and help relieve pain. Use as directed.
  • Wearing a wrist splint
    • This will keep the nerve in a neutral position, preventing further damage.
      In more severe cases, a cortisone injection into the carpal tunnel area is often helpful in relieving symptoms for weeks to months at a time and can be repeated if needed. If an underlying disease like hypothyroidism (an underactive thyroid) or rheumatoid arthritis is causing the carpal tunnel syndrome, treating the disease may also provide relief.

If nonsurgical measures fail to relieve carpal tunnel syndrome symptoms, then surgery, known as carpal tunnel release, may be needed in order to open the carpal tunnel and relieve pressure on the median nerve. The surgery may be an open surgical procedure or an endoscopic procedure, and can usually be done on an outpatient basis, meaning patients return home later the same day as the procedure.

What is Recovery From Carpal Tunnel Syndrome Like?

If treated, during the healing process, the ligament tissues gradually fuse back together, while granting more room for the nerve than existed before. You will be encouraged to use your hand as often as possible, easing back to normal use while avoiding extreme wrist positions or forceful hand motions.

Soreness or weakness may take several weeks to a few months to resolve. When completely healed from surgery, a majority of patients report lasting pain relief thanks to the carpal tunnel release surgery.

If you are experiencing prolonged feelings of tingling, numbness or weakness, it is important to schedule an appointment with a hand and wrist specialist as soon as possible to minimize discomfort, recovery and long term effects.