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Carpal Tunnel Syndrome

The carpal tunnel is a slim corridor of bones, muscles and ligaments in the wrist on the palm side of your hand. The corridor, or tunnel, provides protection for the main nerve to your hand and the nine tendons that enable your fingers to bend.
Carpal Tunnel Syndrome occurs when you feel pain in the surrounding tendons, ligaments, and muscles that press on the median nerve, the only nerve that passes through the carpal tunnel. The carpal tunnel, which is the passageway where the median nerve is located, is narrow and thus the median nerve can be irritated easily.

Symptoms

The onset of Carpal Tunnel Syndrome is usually, at least initially, accompanied by the sensation of tingling and numbness in the fingers. Other common symptoms include:

  • Burning, tingling, and numbness in the palm
  • Pins and needles sensations that tend to be more prevalent in the thumb, index, middle and ring fingers
  • A loss of grip strength, which often results in the dropping of objects
  • Decreased sensitivity to hot and cold
  • Aching in the forearm below the elbow
  • Difficulty making a fist

Diagnosing Carpal Tunnel Syndrome

Determining the cause of Carpal Tunnel Syndrome can be elusive because there are many unknown factors. Some common contributors are believed to be repetitive motion, obesity, pregnancy, hypothyroidism, arthritis, diabetes, and trauma.
Your doctor will perform a battery of tests to help determine if you have Carpal Tunnel Syndrome. A physical examination, which will test strength in your fingers and muscle strength in your hands, is usually the first step. Putting pressure on the median nerve in your wrist may or may not cause pain.

An X-ray may be the next step and could enable your physician to rule out arthritis or a fracture, if they are indicated.

Additional tests could include an electromyography to determine the electrical activity in your muscles, or a nerve conduction study in which electrical impulses are passed through the median nerve to determine if they are slowed by a constricted carpal tunnel.

Treatment Options

If your physician determines you are suffering from Carpal Tunnel Syndrome, treatment options include basic, common sense solutions like taking frequent breaks to rest your hands and wrists, and applying ice to alleviate swelling. Other options include:

  • A wrist splint, especially worn while sleeping, can help ease numbness and tingling while also keeping the wrist from bending.
  • Anti-Inflammatory drugs, such as ibuprofen, may provide temporary relief.
  • A corticosteroid injection to relieve pain and swelling.
  • Persistent Carpal Tunnel Syndrome, which does not respond to more conservative treatment, may require surgery to relieve pressure on the median nerve.

In Carpal Tunnel Release surgery, the wrist and hand area are numbed.

The surgeon, using a small camera connected to a monitor (which is called endoscopic surgery), makes a small incision in the palm of the hand near the wrist. The ligament that covers the carpal tunnel is then cut to ease pressure on the median nerve. Some tissue surrounding the nerve is also removed. Finally, the surgeon stitches the skin and tissue closed.

The surgery is performed on an outpatient basis. After the procedure, the wrist will be in a splint or bandage for about one week. Once the splint or bandage is removed, the patient will proceed to physical therapy.

UOA Hand & Upper Extremity Department

In addition to treating general orthopaedic conditions, each of our physicians is fellowship trained in a subspecialty. The physicians at University Orthopaedic Associates Hand & Upper Extremity Department are expert in treating and diagnosing Carpal Tunnel Syndrome.

The Hand & Upper Extremity specialists use the latest technology and innovative approaches to treat conditions like Carpal Tunnel Syndrome.

To request an appointment to consult with one of our Hand & Upper Extremity specialists at one of our three locations (Somerset, Princeton and Wall Township), please fill out the Make an Appointment Form on our website.

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