Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common, painful, progressive condition that is caused by the compression of the median nerve at the wrist area.

Symptoms

Common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except your little finger, pain and burning sensation in your hand and wrist that may radiate up the arm and elbow, and weakness in your hand with diminished grip strength.

Causes

The exact cause of the condition is not known. However, certain factors increase the risk of developing carpal tunnel syndrome. They include

• Congenital abnormalities
• Repetitive motion of the hand and wrists
• Fractures and sprains
• Hormonal imbalance
• Other medical conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, gout, overactive pituitary gland or the presence of a cyst or tumor in the canal

Conservative treatment options

Carpal tunnel syndrome may be treated using conservative approaches or surgery. The conservative treatments include:

• Treating the underlying medical conditions
• Immobilization of the hand and wrist with a splint or wrist brace for 4-6 weeks
• Resting the hand for 2 weeks or more
• Ice packs to avoid swelling
• Avoiding activities that tend to worsen the symptoms
• Medications such as non-steroidal anti-inflammatory drugs and steroid injections
• Strengthening and stretching exercises, once symptoms diminish

Surgery

If conservative treatment options fail to resolve the condition, your surgeon may recommend a surgical procedure. Carpal tunnel syndrome can be treated with carpal tunnel release surgery. The traditional surgery involves an incision of up to 2 inches in the palm and wrist area; whereas, endoscopic surgery involves one or two half-an-inch incisions and the use of an endoscope. During the surgery, the transverse carpal ligament will be dissected to release the pressure on the median nerve and enlarge the carpal tunnel. Your surgeon will decide the best options for you based on your general and medical conditions.

Postoperative care

Your surgeon may suggest certain postoperative practices for better recovery and to avoid further complications.

• Elevate your hand above your heart level to reduce swelling.
• Apply a splint.
• Apply ice packs to the surgical area to reduce swelling.
• Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering.
• Physical therapy may be ordered to restore wrist strength.
• Eating a healthy diet and not smoking will promote healing.

Risks and complications

Majority of patients suffer no complications following carpal tunnel release surgery. However, some patients may suffer from pain, infections, scarring and nerve damage, causing weakness, paralysis, or loss of sensation and stiffness in the hand and wrist area.