What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a common, painful, progressive condition caused by compression of the median nerve in the wrist area.
Carpal Tunnel Syndrome Symptoms
Common symptoms of carpal tunnel syndrome include numbness and tingling in all fingers except the little finger, pain and burning sensation in the hand and wrist radiating to the arm and elbow, and decreased grip strength and weakness in your hand.
Causes of Carpal Tunnel Syndrome
The exact causes of the condition are unknown. However, certain factors increase the risk of developing carpal tunnel syndrome:
- Congenital abnormalities
- Repetitive movement of the hands and wrists
- Fractures and sprains
- Medical conditions such as hormonal imbalance
- Hypothyroidism
- Rheumatic joint inflammation
- Diabetes
- Obesity
- Overactive pituitary gland
- Presence of cyst or tumor in the canal
Conservative Treatment Options for Carpal Tunnel Syndrome
Carpal tunnel syndrome can be treated using conservative approaches. Conservative treatments include:
Treatment of Underlying Medical Conditions
- Hand and wrist immobilization with splint or wrist splint for 4-6 weeks
- Rest your hand for 2 weeks or more
- Ice packs to prevent swelling
- Avoid activities that tend to worsen symptoms
- Medications such as non-steroidal anti-inflammatory drugs and steroid injections
- Strengthening and stretching exercises when symptoms subside
- Carpal Tunnel Syndrome Relieving Surgery
- If conservative treatment options fail to resolve the condition, your surgeon may recommend surgery.
Carpal tunnel syndrome can be treated with carpal tunnel release surgery. Conventional surgery involves an incision of up to 2 inches in the palm and wrist area, while endoscopic surgery involves one or two half-inch incisions and the use of an endoscope. During surgery, the transverse carpal ligament will be dissected to release pressure on the median nerve and widen the carpal tunnel. Your surgeon will decide which options are best for you based on your general and medical condition.
Post-Carpal Tunnel Syndrome Relief Surgery Care
Your surgeon may recommend that you perform certain postoperative procedures to heal better and avoid further complications.
- Raise your hand above heart level to reduce swelling.
- Wear a splint.
- Place a towel-wrapped ice pack on the surgical site to reduce swelling.
- Keep the surgical incision clean and dry. Cover the area with plastic wrap while bathing or showering.
- Physical therapy may be requested to restore your wrist strength.
- Preferring healthy diet meals and not smoking will accelerate recovery.
Carpal Tunnel Syndrome (CTS) Frequently Asked Questions
What is Carpal Tunnel Syndrome and what causes it?
Carpal Tunnel Syndrome (CTS) is a common condition that causes numbness, tingling, and pain in the hand and arm. The condition occurs when one of the major nerves to the hand—the median nerve—is squeezed or compressed as it travels through the wrist.
The “tunnel” is a narrow passageway on the palm side of your wrist made of bones and ligaments. Pressure on the nerve can be caused by swelling of the lining of the flexor tendons, joint dislocations, fractures, or even fluid retention during pregnancy. While repetitive hand motions are often blamed, many cases are due to a combination of genetic and lifestyle factors.
What are the typical symptoms of Carpal Tunnel Syndrome?
Symptoms usually start gradually and may include:
- Numbness and Tingling: You may feel a “pins and needles” sensation in your fingers (especially the thumb, index, middle, and ring fingers).
- Night-time Discomfort: Many people wake up with the need to “shake out” their hands.
- Weakness: You may experience a loss of grip strength and find yourself dropping objects.
- Radiating Pain: Burning or aching that travels from the wrist up the arm toward the shoulder.
How is Carpal Tunnel Syndrome diagnosed?
Diagnosis usually begins with a physical exam where a doctor tests the feeling in your fingers and the strength of the muscles in your hand. Common tests include:
- Tinel’s Sign: The doctor taps over the median nerve at the wrist to see if it causes tingling.
- Phalen’s Test: You hold your forearms vertically and point your fingers down for 60 seconds to see if symptoms appear.
- Electromyography (EMG) and Nerve Conduction Studies: These tests measure the electrical activity in your muscles and the speed of signals in the median nerve to confirm compression.
Can Carpal Tunnel Syndrome be cured without surgery?
Yes, mild to moderate cases can often be managed with nonsurgical treatments if caught early. Common strategies include:
- Wrist Splinting: Wearing a brace at night to keep the wrist in a neutral position, which relieves pressure on the nerve.
- NSAIDs: Anti-inflammatory drugs like ibuprofen can help reduce swelling.
- Corticosteroid Injections: These can provide temporary relief by reducing inflammation around the nerve.
- Activity Modification: Changing the way you use your hands or adjusting your workstation ergonomics.
When should I consider Carpal Tunnel release surgery?
Surgery is usually considered if nonsurgical treatments fail to provide relief after several months, or if there is evidence of nerve damage (such as muscle wasting in the thumb or persistent numbness).
The procedure, called “Carpal Tunnel Release,” involves cutting the ligament that forms the roof of the tunnel to increase the size of the passageway and decrease pressure on the median nerve. It is typically a quick, outpatient procedure with a high success rate.
How long does recovery take after Carpal Tunnel surgery?
Recovery varies by individual. While you may notice an improvement in symptoms like night pain almost immediately, full healing can take several months to a year. You will likely wear a bandage or splint for the first week or two.
Gradual return to activities is encouraged, though heavy lifting and repetitive motions should be avoided for several weeks. Hand therapy is often recommended to restore strength and flexibility.
