Carpal Tunnel Syndrome

The carpal tunnel is an enclosed space within the wrist where nine tendons run adjacent to the median nerve. With limited space for all of these different residents of the tunnel, the nerve can easily become compressed, causing numbness or tingling of the first three and a half fingers of the hand (thumb, index, middle, and half of the ring). This extremely common condition is known as carpal tunnel syndrome.

In the early stages of carpal tunnel syndrome, symptoms like tingling will be temporary and eventually return to normal. If the condition gets worse, the sensation may become continuous. Tingling is often worse at night or first thing in the morning. Patients also describe having difficulty gripping an object, such as a cell phone or newspaper. If left untreated, the muscles at the base of the thumb can deteriorate permanently over time.

Treatments

The goal of treatment for carpal tunnel syndrome is to improve the feelings of numbness, tingling, and pain while also ensuring the disease process does not progress to cause irreversible damage to the median nerve. Our treatment options for carpal tunnel syndrome include:

Non-Surgical Treatments

Bracing or Splinting

Wearing a padded brace or splint can keep the elbow in a slightly flexed position, reducing pressure on the nerve.

Medication and Supplements

Over-the-counter Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen or prescription-strength options can help reduce pain and inflammation. In some cases, vitamin B6 (Pyridoxine) supplements may be recommended to support nerve health.

Corticosteroid Injections

Corticosteroid injections around the affected area to reduce inflammation and pain temporarily.

Surgical Treatments

Endoscopic Carpal Tunnel Surgery

Endoscopic carpal tunnel surgery is done to relieve pressure on the median nerve by cutting the ligament that is pressing on it. The procedure involves a very small transverse incision on your wrist and the introduction of cameras to see on the inside of your hand. Your surgeon will then use a specialized internal blade to cut the “transverse carpal ligament” to release the pressure on the median nerve.

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Why Patients Trust the Center for Hand & Upper Extremity Surgery

The Center for Hand and Upper Extremity is a premier destination for carpal tunnel treatment, utilizing the latest minimally invasive techniques and advanced technologies. Our state-of-the-art ambulatory centers streamline the treatment process for patients while ensuring the utmost attention to safety, quality, and personalized care.

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When to Seek Medical Attention

See your doctor promptly if your symptoms wake you up at night, last for more than a week, or make it difficult to perform daily tasks. You should also get medical attention if you have muscle weakness or loss of coordination in the affected hand. Don't ignore the warning signs - getting prompt treatment can help relieve symptoms and prevent long-term complications from carpal tunnel syndrome.

FAQs

What causes carpal tunnel syndrome?

Although there have been many theories for why carpal tunnel syndrome occurs (related to work, repetitive activities, specific motions, etc.), the reality is that the true cause is usually unknown. Generally speaking, it is an issue of space – when the nerve does not have enough space, it can become compressed, and this can, in turn, cause symptoms.
Other ways that the nerve can become compressed include:

Swelling of the lining of the flexor tendons, called tenosynovitis
Joint dislocations
Fractures
Joint or bone disease, such as arthritis
Fluid build-up during pregnancy
Repeated repetitive motions with the hands (such as typing or with sports)

What is the difference between carpal tunnel syndrome and arthritis?

Carpal tunnel syndrome is a nerve disorder, while arthritis results from inflammation of the joints. The pain and numbness that occurs with carpal tunnel affects your thumb, index finger, middle finger, and part of your ring finger, while arthritis causes pain in the wrist, knuckles, and finger joints. Some symptoms, such as weakness or inability to grab objects, may overlap, but the mechanisms for why this occurs with each condition are different. Due to these differences, treatment approaches can vary.

How is carpal tunnel syndrome diagnosed?

Your doctor will perform a physical exam combined with the story of your injury to determine if carpal tunnel syndrome is suspected. Additional testing can also help diagnose carpal tunnel syndrome, including:

A Nerve Conduction Study and Electromyography
Ultrasound or X-Ray
MRI

How long does endoscopic carpal tunnel surgery take?

The surgery typically takes less than an hour to complete and is performed under local anesthesia.

What is recovery like after endoscopic carpal tunnel surgery?

After surgery, the stitches are removed in 10-14 days. Hand therapy is started soon after surgery to prevent stiffness and restore function. Most people experience significant relief of carpal tunnel symptoms after several weeks of healing.

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