Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. The condition occurs when one of the major nerves to the hand the median nerve is squeezed or compressed as it travels through the wrist.
Causes
Most cases of carpal tunnel syndrome are caused by a combination of factors. Studies show that women and older people are more likely to develop the condition.
Other risk factors for carpal tunnel syndrome include: - Heredity
- Repetitive hand use
- Hand and wrist position
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- Health conditions
Symptoms Symptoms of carpal tunnel syndrome may include: - Numbness, tingling, burning, and pain—primarily in the thumb and index, middle, and ring fingers
- Occasional shock-like sensations that radiate to the thumb and index, middle, and ring fingers
- Pain or tingling that may travel up the forearm toward the shoulder
- Weakness and clumsiness in the hand—this may make it difficult to perform fine movements such as buttoning your clothes
Many patients find that moving or shaking their hands helps relieve their symptoms.
Doctor Examination
Physical Examination
During your evaluation, your doctor will talk to you about your general health and medical history and will ask about your symptoms.
Check for weakness in the muscles around the base of your thumb
Look for atrophy in the muscles around the base of your thumb. In severe cases, these muscles may become visibly smaller.
Tests - Electrophysiological tests
- Close up of an EMG being performed with a nerve conduction study.
- Electrophysiological tests may include:
- Nerve conduction studies
- Electromyogram (EMG)
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- Magnetic resonance imaging (MRI) scans
Treatment
Although it is a gradual process, for most people carpal tunnel syndrome will worsen over time without some form of treatment. For this reason, it is important to be evaluated and diagnosed by your doctor early on. In the early stages, it may be possible to slow or stop the progression of the disease.
Nonsurgical Treatment
If diagnosed and treated early, the symptoms of carpal tunnel syndrome can often be relieved without surgery. If your diagnosis is uncertain or if your symptoms are mild, your doctor will recommend nonsurgical treatment first.
Wearing a splint or brace reduces pressure on the median nerve by keeping your wrist straight.
Surgical Treatment
If nonsurgical treatment does not relieve your symptoms after a period of time, your doctor may recommend surgery.
The decision whether to have surgery is based on the severity of your symptoms—how much pain and numbness you are having in your hand. In long-standing cases with constant numbness and wasting of your thumb muscles, surgery may be recommended to prevent irreversible damage.
Recovery
You should expect some pain, swelling, and stiffness after your procedure. Minor soreness in your palm may last for several weeks to several months.
You may have to wear a splint or wrist brace for several weeks. You will, however, be allowed to use your hand for light activities, taking care to avoid significant discomfort. Driving, self-care activities, and light lifting and gripping may be permitted soon after surgery.
Your doctor will talk with you about when you will be able to return to work and whether you will have any restrictions on your work activities.
Complications
Although complications are possible with any surgery, your doctor will take steps to minimize the risks. The most common complications of carpal tunnel release surgery include:
- Bleeding
- Infection
- Nerve aggravation or injury
Reference:
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