Carpal Tunnel Syndrome (Median Nerve Compression)

Overuse of the wrist and hand causes related pain and numbness due to compression of the medial nerve - a condition sometimes called carpal tunnel syndrome.

What You Need To Know About Carpal Tunnel

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is one of the most common problems seen by hand surgeons, affecting an estimated 3-5% of people during their lifetimes. Initial carpal tunnel treatment usually involves wearing a brace at night If symptoms worsen, surgery may be recommended to repair the carpal ligament.

Carpal tunnel syndrome causes pain and numbness in various parts of the hand, including the thumb, index, and long fingers. The carpal tunnel is located on the palm side of the wrist and is comprised of bones and ligaments. Compression on the median nerve at the wrist from repetitive hand motions can lead to numbness, tingling, and weakness in the hand and arm.

If left untreated, carpal tunnel syndrome will progress, leading to a loss of hand coordination and discomfort from simple tasks, such as typing on a keyboard or slicing onions.

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome can develop from many different sources. Compression on the median nerve can occur from an injury sustained from sports, such as a sprain. For instance, a boxer may damage their median nerve due to the accumulation of trauma while training. Also, injuries to the wrist joint may result in symptoms.

Jobs that involve repetitive wrist movement may gradually lead to trauma on the median nerve, such as occupations in manufacturing, construction work, or keyboarding occupations. Even the excessive use of vibrating hand tools, such as a jackhammer, may contribute to compression on the median nerve. Excessive wrist motion or overextension may lead to a swelled or compressed median nerve. Inadequate positioning on a computer keyboard or improper technique on a music instrument can also cause damage from repeated movement.

Hereditary issues may also result in carpal tunnel syndrome. Conditions like overactive pituitary glands, underactive thyroid glands, and rheumatoid arthritis are known to contribute to carpal tunnel symptoms. Other common conditions or factors related to carpal tunnel include:

  • Diabetes

  • High blood pressure

  • Autoimmune disorders

  • Cyst or tumors in the canal

Age and gender are often responsible for symptoms. Women are three times more likely than men to develop symptoms. Pregnancies, menopause, and hormonal changes may result in fluid retention and increased pressure on the carpal tunnel. Older adults are also more likely to develop carpal tunnel due to the gradual degradation of joints and bones.

Poor lifestyle factors may increase the risk of carpal tunnel. A high body mass index (BMI), sedentary lifestyle, smoking, or high salt intake are commonly responsible for symptoms, because they may lead to high blood pressure.

Carpal Tunnel Symptoms

Carpal tunnel symptoms include numbness,and pain or tingling in the hand, most commonly in the thumb, index, and long fingers.

During the early stages of carpal tunnel syndrome, symptoms are typically intermittent during the day, but as the disease progresses, the pain or numbness may become constant and even disrupt sleep.

Certain activities, such as reading, driving, or typing, may make the numbness or pain worse. The general weakness of damaged muscles may make it difficult to hold objects, type on a keyboard, and do other daily activities. Permanent nerve or muscle damage may occur without proper treatment. It is crucial to see your doctor to address carpal tunnel symptoms and develop a treatment plan.

How Carpal Tunnel is Diagnosed

Carpal tunnel syndrome is most often diagnosed through a patient's history and physical exam. Early diagnosis is imperative to prevent permanent and prolonged damage.

A physical exam will help doctors verify the cause of the nerve compression at the carpal tunnel and identify proper treatment. Every condition is unique. Your doctor will be able to create a customized treatment plan designed to promote your healing.

In addition to your physical exam, nerve conduction studies are often used in making a diagnosis. Nerve conduction studies are performed during a separate appointment, typically with a Physical Medicine and Rehab physician or with a Neurologist. Practitioners can evaluate how quickly electrical signals travel along the nerve. If the nerve is compressed, the signal travels more slowly. Nerve conduction studies are crucial to help physicians make an accurate diagnosis.

Book an appointment with the experts at the Resurgens Hand and Wrist Center to learn more.

Treatment for Carpal Tunnel Syndrome

There are several options to help alleviate carpal tunnel symptoms. Surgery is only recommended for severe conditions.

Initial carpal tunnel treatment usually involves a wearing a brace at night. The brace holds the wrist straight, giving the nerve the most space within the carpal tunnel.

Your physicians may suggest ergonomic changes to relieve pain from strenuous activities. These changes may include using gel pads in front of your keyboard, or simple hand stretches to relieve pain.

Steroid injections are sometimes usedfor temporary relief. Non-steroidal anti-inflammatories and mild pain medication may also be prescribed.

If symptoms continue despite non-operative treatment measures, surgery may be recommended.

Carpal tunnel release surgery is a minimally invasive procedure that releases the transverse carpel ligament. There are various methods by which this can be achieved, including through open, mini-open, and endoscopic surgery. All have been shown to be effective methods of decompressing the median nerve.

After surgery, the wrist is typically placed into a soft dressing, and finger motion is encouraged. Patients are often able to return to typing within a few days, though the return to manual labor jobs and heavy lifting may take several weeks.

Schedule an appointment at Resurgens for an initial examination and to discuss treatment options.

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