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Carpal Tunnel Syndrome

What is the carpal tunnel?

The carpal tunnel is a long tunnel that runs through the wrist and hand on the palm side. This tunnel encapsulates the nine tendons that allow you to move your fingers, as well as the median nerve, which is responsible for sensation in the hand and fingers.

How does carpal tunnel syndrome develop?

Carpal tunnel syndrome (CTS) occurs when the carpal tunnel compresses the median nerve. When this nerve is pinched, weakness and loss of sensation may occur in the hand. There are many possible causes of median nerve compression. Common causes include: wrist fracture or dislocation, cysts, tumors, swelling and inflammation (often caused by rheumatoid arthritis), diabetic polyneuropathy, edema (fluid retention), hypothyroidism, obesity (when combined with certain wrist anatomy), occupational stress, and repetitive use of vibrating hand tools. In many cases, carpal tunnel syndrome is idiopathic, meaning no cause can be ascertained.

What are the symptoms of carpal tunnel syndrome?

In its early stages, carpal tunnel syndrome may only cause a dull ache in the wrist. This sensation may also extend to the hand and forearm. As medial nerve compression worsens, CTS may cause:

  • Tingling or numbness in the fingers or hand – especially when gripping an object. This particular symptom tends to worsen at night.
  • Radiating pain that extends all the way through the fingers, arm, and shoulder on the palm side. This pain may worsen after forceful or repetitive use.
  • Weakness in the hands, which may cause you to drop objects or have a weak grip.

How can I lessen the symptoms of CTS?

If you suffer from carpal tunnel syndrome, you may be able to alleviate symptoms by following these guidelines:

  • Take frequent breaks from repetitive activities.
  • Avoid activities that worsen your symptoms.
  • Stretch and rotate your wrists, palms, and fingers.
  • Wear a wrist splint when you sleep to keep your wrist straight. Many people experience symptoms that worsen at night because they sleep with their wrist bent.
  • Use anti-inflammatory pain-relievers when you need them.

To help prevent carpal tunnel syndrome, implement these practices in your daily life:

  • Avoid repetitive motions by changing your hand position frequently. If you have to perform a task over and over, try it from different angles.
  • Keep your wrists in a neutral – not bent – position when relaxed.
  • Use your whole hand to grip – not just the thumb and index finger.
  • Take plenty of breaks from wrist-intensive activities.
  • Strengthen your hand and forearm muscles.
  • Move slowly – no quick, snappy movements with the wrist.

How is carpal tunnel syndrome treated?

At Hedley Orthopaedic Institute, your physician will evaluate your symptoms in order to determine the best treatment option. Unless your symptoms are severe, your physician will likely begin with a non-operative treatment option, such as wrist splinting or drug therapy. Steroid injections and other treatment options may provide symptomatic relief by decreasing swelling and alleviating pressure on the median nerve. However, drug therapy cannot treat or “cure” carpal tunnel syndrome; it can only manage symptoms. Ultimately, most patients will need carpal tunnel release surgery performed by a hand surgeon.

What is carpal tunnel release surgery like?

Carpal tunnel release surgery is a procedure that aims to relieve pressure on the median nerve by cutting the ligament that presses on the nerve. CTS release surgery may be performed using an endoscopic or open approach. Dr. Hanlon, a Phoenix hand surgeon at Hedley Orthopaedic Institute, discusses the pros and cons of these two approaches below.

At Hedley Orthopaedic Institute, an open surgical approach tends to be the preferred method for carpal tunnel release. While “open” might recall associations with “open heart surgery” or other highly invasive procedures, open carpal tunnel release surgery is quite different. The procedure takes only about ten minutes to complete, and the incision in the palm is just 2 cm in length (about three-quarters of an inch). In fact, the procedure is usually done with just regional anesthesia and intravenous sedation, which allows the patient to fully relax without being “put under.”

Meet With a Hand Surgeon in Phoenix, Mesa or Tempe

At Hedley Orthopaedic Institute, your hand surgeon will discuss all of your options with you prior to scheduling an operation for carpal tunnel release. To schedule an appointment with an orthopaedic surgeon in Phoenix, Tempe, or Mesa, contact us.

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