Carpal Tunnel Syndrome

Overview

Carpal tunnel syndrome, also commonly referred to as median nerve compression, is a hand condition that is characterized by numbness, tingling, or weakness in the hand. It occurs when the median nerve becomes compressed. The median nerve is a key nerve in the hand that controls the movement of your thumb and all other fingers except your pinky.

Carpal tunnel syndrome can be treated. Treatment will vary depending upon the severity of your case and the underlying cause.

Carpal Tunnel Syndrome causes

Several factors cause Carpal Tunnel Syndrome. Most commonly, it develops from a condition that places pressure on the median nerve that runs through the hand and wrist.

Activities or conditions that may cause carpal tunnel include:

• Typing
• Repetitive hand/wrist movements
• Hypothyroidism
• Obesity
• Rheumatoid arthritis
• Pregnancy
• Diabetes
• Trauma

Carpal Tunnel Syndrome symptoms

Symptoms of carpal tunnel syndrome include:

• Pain, burning, numbness, or burning in the thumb and all the fingers except the pinkie finger.
• Periodic shock-like sensations that affect the thumb and fingers.
• Difficulty with movements such as tying your shoe.

Carpal tunnel syndrome begins slowly and progressively worsens. Symptoms often appear at night or while holding an object such as a phone for an extended period.

Carpal Tunnel Syndrome complications

Carpal tunnel syndrome can lead to weakness or inability to move your fingers or thumb if left untreated.

Carpal Tunnel Syndrome risk factors

Several factors can increase your likelihood of developing carpal tunnel syndrome, including:

• Genetics.
• Using the hand in repetitive movements.
• Performing activities that require flexion or extension of the hand or wrist.
• Being pregnant.
• Having health conditions such as diabetes, rheumatoid arthritis, and thyroid gland imbalance.

Carpal Tunnel Syndrome prevention

While carpal tunnel syndrome is often challenging to prevent, some methods may help delay the onset, including:

• Ensure you are using proper hand and wrist placement on a computer or workstation.
• Sleep with your wrists in a straight position.
• Avoid curling your wrist in and out repetitively.
• Take breaks from any activities that require repetitive hand movement.
• Monitor any conditions that are associated with carpal tunnel syndrome.

Carpal Tunnel Syndrome diagnosis

Your doctor can diagnose carpal tunnel syndrome. During a clinic visit, your doctor will take a full medical history, evaluate your symptoms, and examine your hands and wrists.

During the examination, your doctor will:

• Examine the inside of your wrist to ascertain if the pressure in certain areas along the median nerve cause numbness or tingling.
• Determine if there is a weakness around the base of the thumb.
• Evaluate the degree of fingernail and hand sensitivity with special instruments.
• Determine if you have muscle atrophy around the base of the thumb.

Your doctor will likely order diagnostic testing such as an X-ray or electromyography to determine how severe the pressure is on the median nerve.

• X-ray — If you have evidence of trauma, arthritis, or limited wrist mobility, your doctor may order an X-ray.
• Electromyography (EMG) — An electromyography study helps your doctor determine if the median nerve is working and if it is appropriately controlling your muscle movement.

Carpal Tunnel Syndrome treatment

Early intervention and treatment for carpal tunnel syndrome are essential. If you are experiencing any early symptoms of carpal tunnel, take frequent breaks to rest your hands, avoid any repetitive movements or activities that make your symptoms more intense and apply ice packs to reduce your swelling.

Your doctor will develop a treatment plan based on the severity of your condition. If you have had mild to moderate symptoms for ten months or less nonsurgical therapy such as splinting or medication may be helpful.

Conservative treatments for carpal tunnel syndrome include:

• A splint can hold your wrist in still during the nighttime hours.
• Medications such as nonsteroidal anti-inflammatory medications can help relieve pain associated with carpal tunnel syndrome.
• A steroid can be injected directly into the affected site to relieve pain and reduce inflammation and swelling.

If nonsurgical methods are not proving effective, surgery may be an option. Surgical techniques for carpal tunnel syndrome include:

• Endoscopic surgery. During endoscopic surgery, your orthopedic surgeon will make an incision into the ligament in your hand or wrist. Generally, the recovery process is quicker with endoscopic surgery.
• Open release surgery. During open surgery, your surgeon will make a larger incision in your palm and cuts through the ligament. The incision will free the nerve.

Your ligaments will usually grow back together after surgery, allowing more space for the nerves than before.

When to Seek Care

If you have symptoms of carpal tunnel syndrome, schedule an appointment with your Bon Secours Mercy Health. The earlier you are treated, the more likely you are to achieve symptom relief with non-surgical therapies.

Next Steps

Before your appointment, take detailed notes of your symptoms, when they are most severe and when they started. Also, write down all your questions for the doctor.

If diagnosed with carpal tunnel syndrome, carefully follow your doctor’s treatment and recovery instructions.

If you had surgery to relieve your symptoms, understand that while you may experience symptom relief after surgery, complete recovery can take months. During the recovery period, most people are not able to grip objects as tightly as before. Some people develop nerve damage, infections, or experience pain at the surgery site. You will likely need to reduce your work activity for a few weeks after surgery.

Most people who have surgery do not experience a recurrence, but many report they do not feel completely normal after surgery.