Carpal tunnel syndrome is the result of too much pressure on a nerve as it enters the hand. The median nerve passes through a tight space at the base of the hand, just past the wrist crease, before it branches out to the fingers. If the pressure on the nerve here is too high, nerve signals cannot travel effectively along the nerve, and we experience numbness and tingling in the fingers. This pressure also frequently causes pain. If the pressure is significant and lasts long enough, the nerve can start to die.
How it might affect you:
The most common symptom of carpal tunnel syndrome is numbness and tingling in the fingers. This can happen only occasionally in mild cases, but may be continuous if the condition progresses. Patients typically talk about problems at night or when they first wake up, or with activities such as driving or using their phone. People often have pain as well. In advanced cases, patients have weakness in their hands and difficulty with fine motor skills such as buttoning a shirt or picking up a coin.
How it is treated:
Treatment for carpal tunnel syndrome may be surgical or non-surgical. Common treatments might include wearing a wrist brace at night, having an injection of steroid medication into the carpal tunnel, or surgery.
It is common for people to sleep with their wrists bent for at least some of the night, and this can pinch off the median nerve at the wrist. It can then be under pressure all night, and the resulting irritation can last through the day until the cycle begins again the next night. Wearing a brace can be helpful by keeping the nerve in as relaxed a position as possible. Sometimes, improvement in symptoms is noticed on the first night of brace wear, and sometimes it might take a few weeks.
Another option is a steroid injection, which can be given in the office. This can help take pressure off of the nerve by reducing swelling around the nerve.
Finally, surgery is an option if non-operative treatment isn’t working, or in more severe cases. This is a day surgery where the pressure on the nerve is relieved through a small incision at the wrist. Recovery after surgery generally has two components – recovery of the surgical wound and recovery of the nerve. Typically, the patient can begin using the hand soon after surgery, but in some cases may have soreness at the base of the hand which may last weeks or months. The nerve recovery can often be rapid and complete, but the more advanced the condition is, the more likely that there is slow or incomplete recovery.
Treatment plans may vary from person to person. If you have any concerns about carpal tunnel syndrome, come in to our clinic and we will work with you to develop a plan that will work for you.