Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when a nerve in the carpel tunnel—an inflexible, narrow space located on the palm side of your wrist—becomes pinched or compressed. This tunnel houses the median nerve and tendons, with a ligament forming the tunnel’s ceiling and a collection of wrist bones forming the other three sides.
A pinched median nerve can result in numbness, tingling, pain and occasional weakness in the hand because that nerve is responsible for feeling and movement for the palm side of the thumb, index, middle and ring finger. It also controls several smaller muscles around the base of the thumb. If the median nerve is entrapped for long enough, it can become permanently damaged.
To find your hand’s carpal tunnel, turn your hand so it’s facing you and bend your wrist. Your hand will come toward you. Your carpal tunnel is found in the area where your wrist bends. Learn more about hand anatomy.
Summit Orthopedics’ hand and wrist specialists provide expert diagnosis and treatment for carpel tunnel syndrome at locations throughout the Minneapolis/St. Paul area.
Symptoms of Carpal Tunnel Syndrome
In the early stages of the condition, carpal tunnel syndrome symptoms typically appear gradually and are inconsistent—they become worse with specific activities and get better with rest. In more advanced cases, symptoms are severe. Common symptoms include:
- A burning sensation in the hand and fingers
- Dropping things
- Grip and pinch weakness
- Interrupted sleep due to worsening pain at night
- Numbness in your fingers
- Tingling in fingers
Carpal Tunnel Syndrome Causes
We don’t always know exactly why carpal tunnel syndrome happens. A combination of factors can lead to the condition. You are more likely to get carpal tunnel syndrome if you:
- Are female
- Are older than 40
- Are overweight or obese
- Are pregnant (from fluid retention)
- Had a wrist dislocation or fracture
- Have a job that involves repetitive hand motion, grip, and wrist flexion
- Have a thyroid condition
- Have arthritis
- Have diabetes
Diagnosis and Treatment for Carpal Tunnel Syndrome
The first step to diagnosis is a carpal tunnel physical exam, which may include a Phalen’s test or Tinel’s sign. These tests check for nerve damage and involve your doctor physically examining your hand as you perform several exercises. Numbness or tingling may be signs of carpal tunnel syndrome.
Once it’s confirmed you have carpal tunnel syndrome, your doctor will explain all the treatment options that will be most successful for your unique situation. Together, you and your doctor will create an individualized treatment plan. The good news is that symptoms of carpal tunnel syndrome can often be relieved without surgery.
Everyone responds to carpal tunnel treatment differently. The primary focus is to reduce swelling in the wrist around the nerve and decrease the pressure placed on it. The goal of treatment is to decrease or eliminate symptoms and restore function.
Your custom treatment plan may include:
Anti-inflammatory Medications
Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, help relieve the pain and swelling that’s common with carpal tunnel syndrome. These medications are often used in conjunction with other treatments.
Bracing
Wearing a brace or splint helps keep your wrist in a straight or neutral position and reduces pressure on the carpal tunnel nerve. You will need to keep your brace on while you sleep to reduce excessive bending of your wrists. In moderate cases of carpal tunnel syndrome, a brace can treat the symptoms on its own.
Physical Therapy
Physical therapy is a nonsurgical treatment option for moderate cases of carpal tunnel syndrome. The goal of physical therapy is to reduce further damage to the median nerve, reduce pain and swelling and improve your hand functioning. After learning how to complete the exercises with your therapist, you’ll do many of the exercises at home.
Some people notice improvement, such as regaining strength and grip in their hands, after hand therapy of the hands.
Cortisone Injections to Reduce Swelling
A cortisone shot is a powerful anti-inflammatory prescription medication. It can effectively treat the pain and swelling around the wrist’s compressed median nerve. A healthcare professional injects the shot in your wrist using a small needle. You will usually notice improvement within a few weeks, but the symptom relief usually isn’t long-lasting, and you may need to repeat the injection after a few months.
Surgery
If your symptoms are severe and nonsurgical treatments don’t help, your doctor may recommend carpal tunnel release surgery to correct carpal tunnel syndrome.
During this procedure, your surgeon will make a small incision in your wrist or hand and cut the transverse carpal ligament—the ligament that places pressure on your median nerve. You receive stitches in your incision.
Most patients return home the same day, and you’ll probably wear a splint for a few weeks as you heal. Following the carpal tunnel surgery, you may still need medication and physical therapy for a smoother and quicker recovery.
Recovery From Carpal Tunnel Syndrome
In some cases, carpal tunnel syndrome will heal on its own with at-home treatment. However, in many cases, carpal tunnel syndrome worsens if you don’t get professional treatment.
Carpal tunnel syndrome varies widely in severity, and recovery time varies as well. Talk to your doctor about what you can expect with your specific situation. When surgery is recommended, it usually takes several months to recover, and it can be as long as a year before you regain hand strength.
Find your Summit Orthopedics hand and wrist expert, request an appointment online or call us at (651) 968-5201 to schedule a consultation.
