Carpal Tunnel Syndrome
What is carpal tunnel syndrome?
The median nerve gives sensation to the thumb, index, long, and parts of the ring fingers. In carpal tunnel syndrome, the median nerve is pinched at the wrist, in a tunnel formed by the wrist bones and a ligament. The median nerve can get pinched when tendons that go through the same tunnel get swollen, tissues around the tendons harden, and in hand positions that make the tunnel smaller.
Carpal tunnel syndrome can be associated with repetitive wrist use, broken wrist bones, arthritis, thyroid imbalances, diabetes, menopause, and pregnancy
What are the symptoms?
- Numbness and tingling in the thumb, index, long, and ring fingers in one or both hands.
- Sometimes, pain and numbness into the wrist and forearm.
- Usually worse at night and can interrupt sleep.
- Worse with activities that bend the wrist, like driving, writing, and typing.
- Come and go at first, but will eventually be all the time.
- In severe cases, the hand muscles shrink, and cause a weak grip, and trouble moving the fingers.
What medical tests will I need?
- X-Rays: to rule out any abnormal bone structures that might be causing your symptoms.
- EMG/NCV (Nerve conduction study): to show whether the median nerve is carrying signals normally and the hand muscles are responding to those signals. In carpal tunnel syndrome, signals can be slow or weak.
How is it treated?
- Braces: wearing these at night keeps the wrist straight and allows the swollen tissues to rest.
- Anti-inflammatory Medicine: controls swelling in the wrist. These include naproxen, ibuprofen, and meloxicam.
- Steroid injections: anti-inflammatories injected into the wrist. This can be repeated every 3 months.
- Carpal Tunnel Release: the goal of this surgery is to prevent symptoms from getting worse, but most patients report resolution of symptoms.
What do I need to know about surgery?
- You will be contacted within 10 business days after your pre-op appointment for pricing and scheduling.
- The surgery will last less than 30 minutes and you will go home the same day.
- There are no restrictions on movement or lifting things.
- Your surgeon will make small incision at the palm base and cut the ligament that is pinching the median nerve.
- The bandage over the incision should be kept clean and dry.
- At your 2 week follow up visit, the sutures and bandage will be removed, and you will begin scar massage.
- If you are having symptoms in the other hand, you will be given the option to have surgery at your 4 week follow up.