Carpal Tunnel Syndrome

Median Nerve CompressionWhat is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is a disorder resulting from pressure on the Median nerve at the wrist. The nerve passes through the carpal tunnel with nine tendons. Swelling around the tendons can eliminate the space available for the nerve resulting in nerve compression. Symptoms often consist of pain, numbness and tingling in the thumb, index and middle fingers. Numbness at night and in the morning is experienced by many patients.

What causes Carpal Tunnel Syndrome?
The cause of Carpal Tunnel Syndrome is most often not known. Diseases such as Diabetes, Hypothyroidism, and Rheumatoid arthritis are often associated with CTS. Any disorder that causes fluid retention can precipitate the symptoms of CTS. Use of a computer keyboard does not cause CTS. However, heavy use of the hands may aggravate the symptoms.

What is the treatment of Carpal Tunnel Syndrome?
The treatment of CTS in the early stages is splinting and avoiding aggravating activities. Splints worn at night help relieve pressure on the nerve, and may be the only treatment needed. Your Doctor may recommend modification of your work or recreational activities.

Carpal Tunnel ReleaseIf splinting fails to adequately control your symptoms your Doctor may recommend an injection of steroids into the carpal tunnel. Steroid injection into the carpal tunnel significantly reduces symptoms in most patients. In addition, up to 22% of patients may be permanently relieved by a single injection. However, in many patients the symptoms return over a period of time.

Surgery is recommended when other treatments fail or if nerve conduction studies show an advanced stage of nerve damage. Carpal tunnel release surgery is an outpatient surgery performed under local anesthesia. If you desire, heavy sedation may be administered during surgery. You can usually return to light activity the day after surgery. Full activity is typically well tolerated after 4 to 6 weeks.

The results of surgery can vary between patients. Numbness and tingling in the hand typically resolves immediately. However, patients with more advanced disease may experience immediate partial recovery followed by gradual improvement over several months in the remaining symptoms. Soreness in the palm is the last symptom to resolve after surgery. Grip strength usually continues to improve for three months after surgery.