Carpal Tunnel Syndrome
AT BEL AIR CENTER FOR PLASTIC AND HAND
Carpal tunnel is a very common--affecting up to 5% of the population. Although the symptoms can be very treatable, many men and women may mistake them for other common hand and wrist conditions. Carpal Tunnel is often diagnosed using electrodiagnostic studies.
Understanding Carpal Tunnel Syndrome
The major nerve and hand tendons travel from the wrist to the hand through a narrow passage called the carpal tunnel. When these nerves are compressed, usually by inflammation in the tendons, they cause numbness, tingling and pain throughout the hand and wrist. These symptoms sometimes even radiate up the arm. Over time, this can cause problems with hand function and muscle weakness. Patients may notice problems making a fist or holding small objects.
Typically, carpal tunnel syndrome only affects one hand, but sometimes it may impact both. The symptoms are noticed mostly in the thumb, index, and middle fingers. Numbness and tingling in the ring and pinky fingers may indicate cubital tunnel syndrome instead. Symptoms are often worse first thing in the morning. They may appear only during certain physical activities that require repetitive or extended wrist movement. Early symptoms may only be periodic; so many people go undiagnosed until they notice symptoms more regularly and often. If left untreated, permanent nerve and muscle damage can occur.
The causes of carpal tunnel syndrome are unknown. Symptoms may appear in patients who have certain medical conditions. Those who have existing hand or wrist injuries or who engage in repetitive activities are also at risk. Tendonitis, arthritis and nerve diseases may also cause symptoms that mimic those of carpal tunnel syndrome.
Surgical Carpal Tunnel Treatment
The initial treatments for carpal tunnel symptoms are typically over-the-counter. These may include anti-inflammatory medications to reduce swelling and inflammation. Sometimes hand therapy to stretch and strengthen the hand and wrist is helpful. A wrist brace worn either at night or during the day can also provide some relief. When more conservative treatments don’t help enough, surgery may be recommended.
Surgery for the treatment of carpal tunnel syndrome is one of the most commonly performed procedures in the United States. There are two approaches to carpal tunnel surgery: open release surgery and endoscopic surgery. During open release surgery, the carpal tunnel ligament is cut to enlarge the tunnel. This relieves nerve pressure.
An endoscopic surgical approach guides a thin, tube-like camera through a tiny incision either in the wrist or palm. This lets the doctor see the wrist structures without fully opening the area. Surgery is performed with the guidance of the camera using small instruments. Endoscopic surgery is less invasive, so healing time is often faster and post-operative discomfort is minimized.
Recovery and Results
Recovery following surgical carpal tunnel treatment occurs gradually. Over time, patients work up to a greater activity level. Incorporating exercise helps the wrist heal properly. Some patients notice an improvement in their symptoms very soon after surgery; the majority of patients experience nearly full relief of symptoms after recovery. It’s very unusual for symptoms to return after surgery.