Carpal Tunnel Syndrome

The carpal tunnel is a passageway in your wrist that surrounds and protects your median nerve, the primary nerve in your wrist. Your median nerve controls movements and feeling in your thumb and most of your hand. It is held in place within the carpal tunnel by ligaments, bones, and tendons. If any one of these structures is inflamed, the space inside the carpal tunnel narrows and puts pressure on the median nerve. This is called carpal tunnel syndrome, a progressive condition that is likely to worsen without appropriate care.

Women have carpal tunnel syndrome three times more frequently as men, with those 55 and older the most commonly affected.

Recognizing Carpal Tunnel Symptoms

Carpal tunnel syndrome symptoms are typically stronger at night but are also felt during the day when performing tasks that include pinching or gripping motions. Specific symptoms include:

  • Numbness, burning, tingling, or pins-and-needles sensation in the thumb, index, and/or middle fingers
  • Pain in the wrist or hand, possibly radiating up the arm
  • Weakness when attempting to grasp objects
  • Lack of coordination in hand
  • Swollen feeling in the hand and fingers

Diagnosing Carpal Tunnel Syndrome

A carpal tunnel syndrome diagnosis begins with your doctor examining your medical and injury history and determining how you have used your hands at home and at work. Your family history will be assessed as well. Laboratory tests or X-rays may be used to exclude other conditions, and your doctor may recommend one of the following additional evaluations to aid in diagnosis:

  • Magnetic resonance imaging (MRI) scan
  • Nerve conduction (NCV) study
  • Electromyogram (EMG) to assess the functionality of hand muscles

Treating Carpal Tunnel Syndrome

To treat carpal tunnel syndrome it is important to try to understand its cause—because symptoms can often be alleviated simply by making ergonomic corrections or changing the way you use your hands. Non-invasive and minimally invasive treatments are frequently successful in treating carpal tunnel syndrome, and include:

  • Wrist splinting
  • Corticosteroid therapy
  • Occupational or lifestyle modifications
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Physical therapy
  • Home exercises

Carpal Tunnel Surgery

If symptoms are severe and are not significantly relieved with conservative treatment, surgery is an option. The goal of carpal tunnel release surgery is to make more space for the tendons and nerves within the carpal tunnel so that the pressure (and the symptoms that come with it) is alleviated. This is accomplished by cutting the ligament that encases the nerve. The surgery is typically performed in less than half an hour and on an outpatient basis, with the patient awake but comfortable and pain-free. Recovery times vary from person to person with most finding significant relief within a few months.

Don’t Ignore Symptoms

If left untreated, carpal tunnel syndrome can cause permanent nerve damage leading to loss of strength and sensation as well as hand atrophy. Seeking a diagnosis and treatment often proves to be an ounce of prevention and a pound of cure.