Carpal tunnel syndrome (CTS) and pain go hand in hand. You may experience a burning pain as though you have put your hand in a snowbank. You might feel like you drop things more often or have less grip strength. Most people have numbness and tingling in their fingertips. While these sensations are strange and troublesome, the symptoms of CTS can be managed with non-surgical and surgical methods. At MOSH, treatment of the underlying cause of carpal tunnel syndrome is as important as symptom relief, so the patient can avoid permanent nerve damage and daily discomfort. Here are our best seven tips for carpal tunnel pain relief.
What Is Carpal Tunnel Syndrome?
Imagine a tube inside your arm that runs from your forearm, through the wrist, and into the base of your hand. This tube is called the carpal tunnel, and its main job is to protect a nerve encased inside the tunnel, known as the median nerve. This big nerve controls movement and sensations in your thumb, index, ring, and middle fingers. The carpal bones, the transverse carpal ligament, and nine tendons keep the median nerve securely inside the carpal tunnel. When there is damage to these supporting structures, they will swell or inflame and squeeze the carpal tunnel, which will compress the median nerve causing carpal tunnel syndrome.
Carpal tunnel syndrome is common, painful, and progressive. Without treatment, the median nerve can be permanently damaged, resulting in chronic pain, loss of use of parts of the hand and fingers, reduced fine motor skills, and proprioception (the ability to sense where your hand is in space).
Carpal Tunnel Symptoms
A syndrome is a collection of symptoms that present in a variety of ways in individuals. You may not experience the same symptoms to the same degree as others with carpal tunnel syndrome, but you will likely want to find relief for whichever sensations you are experiencing. CTS signs can start gradually and often become worse at night. Most symptoms occur in the forearm, wrist, hand, or fingers. Some symptoms of carpal tunnel syndrome include:
- Pain: aching, sharp, shooting, stabbing or a burning or cold sensation, often in the thumb and index finger
- “Electric” or “crawling” sensations
- Weakness or a loss of grip strength
- Numbness and tingling (also described as pins and needles)
- A swollen feeling in hands and fingers
More advanced carpal tunnel syndrome often has these symptoms:
- Pain and weakness radiating into your upper arm
- Increased difficulty picking up small objects
- Decreased feeling in your fingers
7 Tips For Carpal Tunnel Pain Relief
Carpal tunnel syndrome is most often the result of repetitive movement from activities like typing, knitting, playing a musical instrument, or participating in sports that involve heavy hand use. Wrist or hand swelling from fractures or pregnancy can also cause temporary carpal tunnel syndrome that resolves after the swelling subsides. No matter how CTS started, you can find pain relief for carpal tunnel using the following seven suggestions.
1. Exercise, Stretch, and Strengthen
Some carpal tunnel pain may be relieved with simple exercises you can do anywhere. It’s essential to consult with your doctor or physical therapist before starting any exercise routine because, in some cases, these hand and wrist movements can exacerbate symptoms. However, the exercises may also help delay surgery, prevent nerve scarring after surgery, and increase blood flow to your hand.
Exercises that slide the median nerve up and down the carpal tunnel are called nerve-gliding exercises. Nerve-gliding is often combined with stretching and strengthening movements. The American Academy for Orthopedic Surgeons has a .PDF carpal tunnel exercise sheet with step-by-step picture instructions.
A common nerve-gliding exercise is a wrist extension stretch:
- Extend your arm, palm down, straight in front of you.
- Bend the wrist up in a “stop” signal.
- Bend your hand back towards you using gentle pressure from your other hand.
- Hold the position for 15 seconds, and repeat five times.
- Do the same on the other hand.
2. Splints And Braces
Most people sleep with their wrists bent, which can make carpal tunnel symptoms even more painful at night. To fix this, wear a splint or brace while you sleep. The wrist brace will keep the wrist in a neutral position, reducing pressure on the median nerve. In addition, if you are performing an activity during the day that may aggravate your condition, like typing, a wrist splint can assist in reducing pain.
What to Look For in a Wrist Splint: A splint and a brace are essentially the same assistive device. A brace is softer, while a splint has a solid or hard component to prevent movement and support an injured area. Splints with a hard insert under the hand and wrist are the best for carpal tunnel pain relief because it keeps the wrist in a position to ease compression on the median nerve.
The splint will cover from below the wrist to the middle of the hand. There needs to be a hole and a separate area for the thumb. The wrist should be unable to move much, and the splint should be tight enough to prevent movement but comfortable enough to wear and not cut off circulation. These types of wrist splints are available over the counter.
3. Pause Often
The best self-care advice is the simplest: if you are experiencing pain while doing an activity, stop doing that activity. Repetitive motion is the main reason people have carpal tunnel syndrome, so take breaks every 15 minutes. Use this pause to do hand and wrist exercises, “shake out” your hands, or wiggle your fingers.
Carpal tunnel syndrome symptoms can also occur when the wrists and hands are in the same position for too long, so pausing between compression-inducing tasks may make a difference between all-day pain and periodic pain. Modifying, alternating, or stopping agitating activities can stop or slow the progression of nerve damage.
4. Ergonomic Changes
Ergonomics for carpal tunnel syndrome aim to keep the wrist and hand in a neutral position and to avoid prolonged periods of flexion or extension in the wrist. For a desk job, try making these modifications:
- Use a mouse that allows your hand and wrist to rest on it comfortably
- Keep your keyboard flat – don’t angle it
- Use a keyboard pad to keep wrists loose and straight
- Use desk pads for hard surfaces
- Keep wrists straight by adjusting the height of the chair or desk (average desks are 27 to 29-inches off the floor)
- Center your work in front of you
Ergonomics can be applied in any workspace and in your home.
5. Medications, Topical Ointments, and Injections
Unfortunately, over-the-counter (OTC) medications don’t always provide relief from carpal tunnel pain. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may reduce inflammation and some pain, so it is best to use medications in conjunction with other treatments. Other studies found topical analgesics containing menthol, like BioFreeze or Tiger Balm, to have some effect on nerve pain symptoms.
Corticosteroid injections, given by a doctor directly into the carpal tunnel, can also lessen some nerve pain by calming the nerve signals and reducing flare-ups. However, like OTCs and ointments, carpal tunnel pain relief is temporary. There are side effects to steroid use, too, like elevated blood sugar, headaches, and tendon and ligament damage. Consult with your MOSH doctor to see if you may benefit from corticosteroid treatments.
6. Temperature Treatments
Easing carpal tunnel pain may be as simple as a change in temperature. These home remedies can be very effective in managing your pain.
- Cold Therapy: Usually, avoiding the cold is the best way to treat CTS pain. However, if the wrist is red or swollen, ice packs and ice baths can help.
- Ice Packs: Apply an ice pack on a towel covering your affected wrist for no more than 15 minutes at a time. The ice pack should never touch bare skin. Repeat 2 to 3 times a day as needed.
- Ice Bath: Wrap your whole hand and wrist in a towel. Gently place the covered areas into an ice bath to soak for 10 to 15 minutes.
- Heat Therapy: Heat therapy can also provide some pain relief but may also treat the underlying inflammation that causes carpal tunnel syndrome. Heat also helps circulation, which encourages the healing and repairing of damaged tissue.
Try these methods to keep your hands and wrists warm:
- Wear gloves or mittens outside in the cold
- Wear fingerless gloves inside that also cover the wrists
- Keep a hand warmer nearby
- Keep the inside heated and warm
- Immerse your hand in warm water (between 92- and 100-degrees F.) Gently move and stretch your hand in the water. Repeat this heated bath three to four times daily.
7. Carpal Tunnel Release Surgery
Carpal tunnel release surgery is often the best way to achieve permanent carpal tunnel pain relief, and to stop the median nerve from becoming more damaged. Reasons to consider surgery include:
- If you’ve experienced no relief of pain or symptoms after six months of conservative treatments.
- If you are experiencing increasing weakness or loss of function in your hand and wrist.
- If you’re constantly feeling Intense pain in your hand and wrist.
- An electromyography test (nerve conduction studies) of the median nerve shows a definitive case of carpal tunnel syndrome.
The three main types of carpal tunnel surgeries are open surgery, endoscopic surgery, and the Guo technique. These surgeries take less than two hours and are outpatient day procedures. You will likely need to be bandaged and wear a splint for one to two weeks following surgery. You may have some very mild post-surgical pain lasting a few days to a week. Over 90% of carpal tunnel release surgeries successfully alleviate symptoms and prevent further nerve damage.
The Last Word: Relief from Carpal Tunnel Pain is Possible
Carpal tunnel syndrome is inconvenient, painful, and progressive. Without proper treatment, burning pain can intensify, the fingers lose feeling, and hand muscles atrophy. While many options might provide carpal tunnel pain relief, only a few of the conservative treatments act to repair the damage. Surgery will likely be required if splints, exercises, and heat fail to relieve symptoms. MOSH has expert orthopedic hand surgeons and post-surgical rehabilitation teams working with the latest technology to get you feeling better faster. If you are experiencing carpal tunnel syndrome or are considering carpal tunnel release surgery, contact us at 414-817-5800, or make an appointment today.
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