carpal tunnel syndrome - south fla orthoHave you ever been working at your desk and your hand and wrist begin to tingle and go numb? Does that happen often? While the discomfort and pain may be something you’re tempted to “ride out,” you may have carpal tunnel syndrome, which might medical treatment to heal.

Carpal tunnel syndrome is a progressive condition caused by a pinched nerve in the wrist. It causes numbness, tingling and pain in the hand and wrist. Carpal tunnel syndrome can be treated with wrist splinting, anti-inflammatory drugs, corticosteroids and, if those methods fail, surgery.

What is Carpal Tunnel Syndrome?

To understand how carpal tunnel syndrome occurs, one must first understand a few aspects of what’s inside the hand. The median nerve runs from the forearm into the palm of the hand. The median nerve is housed by the carpal tunnel, a narrow passageway of ligament and bones. The thickening from irritated tendons and swelling can crowd, irritate or compress the median nerve which causes pain and discomfort. When this occurs, the resulting diagnosis is carpal tunnel syndrome.

Swelling and inflammation of the median nerve can be caused by fractures, rheumatoid arthritis, hypothyroidism, work stress, repeated use of vibration tools or fluid retention during pregnancy or menopause. Sometimes, carpal tunnel syndrome occurs because the carpal tunnel is smaller in some people than in others.

Some factors are more associated with carpal tunnel syndrome than others. Women are three times more likely than men to develop carpal tunnel syndrome. The dominant hand is also usually affected first. Nerve-damaging and inflammatory conditions such as diabetes and rheumatoid arthritis increase the chances of a person having carpal tunnel syndrome.

What are the symptoms of Carpal Tunnel Syndrome?

When the median nerve becomes compressed, it can cause pain, weakness or numbness in the hand, wrist and sometimes in the arm. Symptoms usually start gradually with numbness and tingling in the thumb, index and middle fingers.

Symptoms include:

  • Tingling or numbness
  • Weakness
  • Feeling the need to “shake out” the hand or wrist
  • Decreased grip strength that makes it difficult to form a fist or grasp small object

How is Carpal Tunnel Syndrome treated?

Carpal tunnel syndrome can be treated with non-surgical and surgical options. When you are first diagnosed with carpal tunnel syndrome, your orthopaedic surgeon will likely create a treatment plan that involves resting the affected hand for at least two weeks, avoiding activities that worsens symptoms and immobilizing the wrist with a splint. You may require further specialized testing called EMG/NCS to further confirm the diagnosis of carpal tunnel syndrome.

Non-surgical treatments

Non-surgical treatments can include wrist splinting, anti-inflammatory drugs, exercise and corticosteroids. Wrist splinting can hold the wrist still, especially while you are sleeping. Anti-inflammatory drugs such as Advil or Motrin can help alleviate pain caused by carpal tunnel syndrome. Strengthening and stretching exercises can help once symptoms have subsided. Corticosteroids can be injected into the wrist and alleviate the symptoms of carpal tunnel syndrome.

Surgical treatments

If carpal tunnel syndrome symptoms persist even after trying nonsurgical treatments or the nerve tests show severe nerve compromise, your orthopaedic surgeon may recommend surgery. Surgery is intended to relieve pressure on the median nerve by cutting the ligament that is pressing on the nerve. There are two types of carpal tunnel syndrome surgery — open release and endoscopic surgery. Our surgeon will discuss with this with you, to determine which surgery is best for them.

Open release surgery – This is the traditional procedure used to correct carpal tunnel syndrome. In open surgery, the surgeon makes a two-inch incision in the palm of the hand over the carpal tunnel. Then, the surgeon will cut the carpal ligament to enlarge the carpal tunnel and free the median nerve. The recovery time is virtually the same as endoscopic surgery, but it will result in more postoperative pain.

Endoscopic surgery – Endoscopic surgery may result in less pain and activity limitations than open release surgery directly following surgery, but the differences in pain are generally small. In endoscopic surgery, the surgeon will use a telescope-like device with a tiny camera attached to it (endoscope). The surgeon will use the endoscope to see inside the carpal tunnel and cut the ligament through one or two small incisions in the hand or wrist. The recovery time is virtually the same as open release surgery.

What are the results of Carpal Tunnel Syndrome surgery?

During the healing process, the ligament tissues will grow back together and allow more room for the median nerve than existed before. After surgery, symptoms of carpal tunnel syndrome will likely be relieved right away. In cases of severe pressure or prolonged period of symptoms, a full recovery may take two to three months. You will be encouraged to use your hand after surgery and gradually work back normal use. You may need physical therapy to restore wrist strength. Following surgery, the recurrence of carpal tunnel syndrome is uncommon.

If you think that you are suffering from carpal tunnel syndrome or you would like to learn more about treatments for carpal tunnel syndrome, request an appointment> or call 772-288-2400.