What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is when the median nerve is compressed as it passes through the carpal tunnel. The carpal tunnel is an opening in your wrist that is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist. The median nerve provides sensory and motor functions to the thumb and 3 middle fingers. If it gets compressed or irritated, you may have symptoms.
Facts About Carpal Tunnel Syndrome
Carpal tunnel release is one of the most common surgeries done in the U.S. Women get carpal tunnel syndrome 3 times more often than men. It usually occurs only in adults.
What Causes Carpal Tunnel Syndrome?
Most cases of carpal tunnel syndrome have no specific cause, although any or all of the following may be a contributing factor:
- Frequent, repetitive, small movements with the hands (such as with typing or using a keyboard).
- Frequent, repetitive, grasping movements with the hands (such as with sports and certain physical activities.
- Joint or bone disease (for example, arthritis, osteoarthritis, or rheumatoid arthritis).
- Hormonal or metabolic changes (for example, menopause, pregnancy, or thyroid imbalance).
- Changes in blood sugar levels (may be seen with type 2 diabetes).
- Other conditions or injuries of the wrist (for example, strain, sprain, dislocation, break, or swelling and inflammation).
- Family history of carpal tunnel syndrome.
What are the Symptoms of Carpal Tunnel Syndrome?
These are the most common symptoms:
- Weakness when gripping objects with one or both hands.
- Pain or numbness in one or both hands.
- "Pins and needles" feeling in the fingers.
- Swollen feeling in the fingers.
- Burning or tingling in the fingers, especially the thumb and the index and middle fingers.
- Pain or numbness that is worse at night, interrupting sleep.
How is Carpal Tunnel Syndrome Diagnosed?
Dr. Hayter will check your medical history and give you a physical exam. He may recommend that you have electrodiagnostic tests on your nerves. These tests are the best way to diagnose carpal tunnel syndrome. Electrodiagnostic tests stimulate the muscles and nerves in your hand to see how well they work.
Treatment of Carpal Tunnel Syndrome?
Together you and Dr. Hayter will determine the best treatment for you based on:
- Your age.
- Your overall health and medical history.
- How bad your wrist is right now.
- How well you tolerate specific medications, procedures, or therapies.
- How bad the disease is expected to get.
- Your opinion or preference.
Treatment may include:
- Splinting your hand. This helps keep your wrist from moving. It also eases the compression of the nerves inside the tunnel.
- Anti-inflammatory medication. These may be oral or injected into the carpal tunnel space. These reduce the swelling.
- Surgery. This eases compression on the nerves in the carpal tunnel.
- Worksite changes. Changing position of your computer keyboard or making other ergonomic changes can help ease symptoms.
- Exercise. Stretching and strengthening exercises can be helpful in people whose symptoms have gotten better. These exercises may be supervised by a physical or occupational therapist.
Surgery for Carpal Tunnel Syndrome
Surgery for carpal tunnel syndrome is usually done as an outpatient. Two types of carpal tunnel surgery are done: open surgery and endoscopic surgery. You may have local or general anesthesia, or both, for either surgery.
During open surgery Dr. Hayter makes a small incision on your wrist. The tissue that is pressing on the nerves is released. This relieves the pressure on the nerve.
After the surgery, your hand and wrist are wrapped and put into a splint. This will help to keep you from moving your wrist during your recovery. Dr, Hayter will give you direction on the length of time you will need to wear the splint. You may have some pain after your surgery. It's usually controlled with pain medication taken by mouth. You may want to sleep with your hand elevated to help ease swelling.
Recovery from carpal tunnel surgery is different for each person. If your nerve has been compressed for a long time, recovery may take longer. You will be encouraged to move your fingers and wrist a few days after surgery to help prevent stiffness.
Together you and Dr. Hayter will discuss your need to adjust your work or home activities while you recover.