What Should I Know About Carpal Tunnel Syndrome?

Estimated to currently affect between four and 10 million Americans, carpal tunnel syndrome is one of the most common nerve disorders diagnosed today according to the American College of Rheumatology.

Carpal tunnel syndrome can be treated effectively with medications, splinting, injections and, if all other treatment methodologies fail, surgery.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition in which there is progressive numbness and eventually weakness in the hand caused by increased pressure on the median nerve in the wrist. The carpal tunnel itself is a narrow space through which nine tendons and the median nerve cross the wrist to reach the hand.

The nine tendons are not necessarily impacted by this increased pressure, rather it is the median nerve that creates the discomfort.

There are a variety of factors that can contribute to carpal tunnel syndrome including pregnancy and underlying health problems such as kidney disease, diabetes or even thyroid disease.

Numbness is usually felt in the index finger, thumb, middle finger and half of the ring finger. If numbness is felt on those four fingers but the little finger is fine, this may be a sign of carpal tunnel syndrome because a different nerve gives feeling to the little finger.

Who is a Candidate for Carpal Tunnel Syndrome Treatment?

Most people with carpal tunnel syndrome complain of intermittent tingling in the hand. For some, the numbness can be very mild and minimally bothersome. These patients may choose to wait for treatment or try to treat the carpal tunnel without medical intervention. For others, it can be so painful that it makes simple tasks such as reading a book, typing on a keyboard or holding a jug of milk difficult and cumbersome. Carpal tunnel syndrome can also cause patients to wake up throughout the night, preventing restful sleep.

The diagnosis is most often seen in people who have already reached middle-age. It is much more common in women than men.

How is Carpal Tunnel Syndrome Treated?

Since the pain and numbness associated with carpal tunnel syndrome is a result of increased  pressure on the on the median nerve, treatments are designed to decrease this pressure.

The sooner treatment is started, the better the chances of relieving symptoms and preventing long-term damage to the median nerve in the hand.

The most common early treatments include using a splint, especially at night to help keep the wrist straight thus lowering the pressure in the tunnel, rest , acetaminophen and non-steroidal anti-inflammatory medications to control inflammation and pain

Another option prescribed by some specialists may be steroid injections. Some, but not all, doctors think steroid injections across the ligaments into the carpal tunnel can provide relief for patients that could last for weeks or months and then be repeated if helpful.

If conservative treatment options do not relieve symptoms, then a carpal tunnel release surgery may be appropriate. This minimally invasive surgery involves cutting the ligament to lower the pressure inside of the tunnel, thus taking pressure off of the median nerve allowing the nerve to heal.

What to Expect After Treatment for Carpal Tunnel Syndrome

If nonsurgical methods of treating carpal tunnel syndrome prove to be successful, patients will experience gradual relief. If surgery is required to treat carpal tunnel syndrome, most patients report feeling relief from the numbness the day of surgery, depending on the length of time the patient has waited to be treated. The area around the incision may be tender for several weeks as the hand heals.

Simple tasks can be done the day of surgery and typing on a keyboard can start shortly thereafter, but it can take several weeks until healing is complete and a return to full activity is permitted.