Carpal Tunnel Syndrome: Treatment ...

Carpal tunnel syndrome is a condition that causes pain, numbness, and weakness in the hand and forearm. According to the American Medical Association, it affects up to 10 million people in the U.S. However, carpal tunnel is often confused with arthritis or normal hand cramps.

Here are the symptoms of carpal tunnel syndrome, treatment options, and the importance of early detection in treating it.

The Anatomy of Carpal Tunnel Syndrome

The carpal tunnel is a narrow passage located on the palm side of the wrist. This passage, surrounded by bones and ligaments, protects the median nerve as it runs through the forearm and into the hand. The median nerve itself is one of the primary nerves in the hand, providing sensation in the fingers and controlling the muscles around the base of the thumb. It originates in a cluster of nerves in the neck, which come together to form a single nerve that runs down the arm and forearm and into the hand via the carpal tunnel.

Carpal tunnel occurs when the carpal tunnel becomes narrowed or compressed, restricting the nerve's natural pathway and putting unusual pressure on the median nerve. This results in the tingling, numbness and weakness most commonly associated with carpal tunnel syndrome. Over time, the condition can worsen, and the continued pressure and compression can lead to permanent nerve damage.

The main difference between carpal tunnel syndrome and arthritis is carpal tunnel affects the nerves in your hands, while arthritis is damage or inflammation to your joints. Arthritis can actually cause carpal tunnel syndrome as well.

RELATED: 5 Common Types of Arthritis

What Causes Carpal Tunnel Syndrome?

The disorder is caused by a compression of the median nerve running through the forearm and wrist into the palm of the hand. Pressure on the nerve as it passes through the wrist results in the pain and numbness associated with the condition.

There are multiple causes of this pressure which, combined with preexisting health conditions, can cause carpal tunnel syndrome.

• Health: Certain underlying medical conditions can contribute to the occurrence of carpal tunnel syndrome. Hypothyroidism, diabetes, and rheumatoid arthritis have all been linked to it. The hormone changes associated with pregnancy can also contribute to occurrences of it in women of childbearing age
• Heredity: The carpal tunnel is smaller in some people than in others and this basic anatomical difference is often a family trait, making heredity one of the more likely contributing factors
• Injuries: certain injuries such as wrist fractures can cause swelling around the carpal tunnel, causing carpal tunnel syndrome.
• Repetitive Hand Motion: Certain activities that involve prolonged flexing or extension of the hand and wrist can often place undue pressure on the median nerve. Prolonged repetition of these activities can cause the tendons in the wrist to swell, placing additional pressure on the nerve, and leading to onset.

Some of the occupational activities that are at the most risk of developing carpal tunnel include assembly line work, manufacturing, construction, or typing on a keyboard.

RELATED: Office Workers & Wrist Pain: When to Seek Relief

What are the Symptoms of Carpal Tunnel Syndrome?

Symptoms of carpal tunnel syndrome include:

• Tingling
• Numbness
• Pain in hand and fingers

In the early stages, the pain and numbness generally center around the thumb, index finger, and middle finger of the affected hand. Gradually, the pain and tingling may begin to travel up through the forearm, often accompanied by an increasing weakness or loss of dexterity. In most cases, these symptoms will come and go at first. However, as the condition worsens, the symptoms will occur more frequently and linger for longer periods.

How Can I Prevent Carpal Tunnel Syndrome?

Preventing carpal tunnel syndrome lies in reducing the stress on your fingers and hands. Some ways to prevent carpal tunnel include:

• Minimize repetitive hand movements
• Loosen harsh grips on tools and other objects
• Take frequent breaks
• Alternate between activities or tasks
• Keep wrists straight
• Avoid holding an object the same way for long
• If you work in an office, keep good posture by keeping your forearms level with your desk or work surface
• Wear a splint at night to keep your wrist straight while sleeping.
• Keep hands warm with gloves in colder months

Why Early Detection of Carpal Tunnel is Important

Carpal tunnel syndrome is a progressive disorder. Early detection is key to the proper treatment of carpal tunnel syndrome, and the sooner the condition is diagnosed the quicker patients can make a full recovery and avoid any potential complications. When symptoms present, and especially if they persist or worsen, it is advisable to seek medical intervention. Your physician or orthopedic specialist will perform a number of tests to determine if carpal tunnel syndrome is the underlying cause of your pain and design a treatment regimen to suit your condition. Fortunately, most cases respond well to conservative treatments, particularly when caught in the early stages before any permanent damage can be done to the median nerve.

Treatment Options for Carpal Tunnel Syndrome

The majority of patients respond positively to conservative treatments, and in most cases it is possible to slow or even stop the progression of the disease through nonsurgical means. When caught in the early stages, nonsurgical treatment typically includes:

Wrist Splinting

Wearing a wrist splint often helps to reduce pressure on the nerve in the carpal tunnel by restricting the movement of the patient's wrist. Typically, wrist splints are worn at night to keep patients from bending their wrists during sleep. However, in some advanced cases, a wrist splint may be worn during the day to avoid aggravating the condition during work or recreational activities.

Medication

Non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen, are often prescribed to reduce inflammation and alleviate pain. In cases that fail to respond to over-the-counter medications, steroid injections may be prescribed to reduce chronic pain and inflammation.

Behavior Modification

Carpal tunnel syndrome and its symptoms are often exacerbated by certain daily activities. In addition to wrist splinting and anti-inflammatory medications, patients are often advised to temporarily avoid or modify work and recreational habits to avoid aggravating their condition.

Occupational Hand Therapy

While occupational hand therapy may be beneficial as a support to nonsurgical treatment, it is more commonly prescribed following carpal tunnel surgery.

Surgical Treatment for Carpal Tunnel Syndrome

While conservative treatments work well for the majority of patients, some may require surgical intervention if their symptoms persist or worsen over time. The surgical procedure involved is called 'carpal tunnel release', and is designed to increase the size of the carpal tunnel and reduce pressure on the median nerve. Essentially surgeons divide the band that is putting pressure on the nerve.

Surgeons rely on two techniques to achieve this end, the 'Open Carpal Tunnel Release' and the 'Endoscopic Carpal Tunnel Release'. Both techniques are minimally invasive, and in most cases the surgery can be performed on an outpatient basis with under general anesthetic. As with any surgical procedure, your physician or orthopedic specialist will guide you through the options and advise you on the surgical procedure that is best suited to your condition.

Recovery from open carpal release surgery is a gradual process, and pain and swelling may linger for several weeks following the procedure. Patients usually do not require occupational therapy but it may take 4-6 weeks before pinch and grip strength begin to return to normal. Patients may also be advised to modify their work and recreational activities until strength and dexterity return to normal.

Carpal Tunnel Syndrome Treatment at Fox Valley Orthopedics

At Fox Valley Orthopedics, our physicians and surgeons are dedicated to keeping our patients healthy and active. If you are experiencing any of the symptoms of carpal tunnel syndrome, we can evaluate your condition and work with you to find the treatment option that best suits your needs and lifestyle. In most cases, conservative treatments and moderate physical therapy achieve the desired results, with patients showing a marked reduction in pain and an overall improvement in strength and dexterity.

If surgery is indicated, our orthopedic specialists are trained in the latest procedures and work closely with trained occupational hand therapists to provide carpal tunnel syndrome patients with the post-operative support they need to make a full recovery and reengage with an active and pain-free lifestyle.

Visit us online to schedule an appointment or call us at (630) 584-1400for more resources.

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