Carpal Tunnel Syndrome: What, How and Next Steps


August 24, 2018 03:37 PM

Doctor examining patient for carpal tunnel syndrome

Have you ever woken up in the middle of the night with a numbness or tingling in your hand? Sometimes, this is harmless, simply your hand falling asleep because you slept on it weird, causing circulation to momentarily cut off. However, if it happens more consistently, this could be a signal that you are developing carpal tunnel syndrome.

WHAT IS CARPAL TUNNEL SYNDROME?

The carpal tunnel is a passageway in your wrist surrounded by bones and ligament. All the tendons which control your fingers, as well as your median nerve, which controls sensation in your hand, travel through your carpal tunnel. Carpal tunnel syndrome occurs when pressure is placed on your carpal tunnel, and subsequently the median nerve, which causes weakness in your hand and a loss of sensation. This pressure is either temporary, caused by holding your hand in a weird position, or more permanent. It becomes more permanent, and serious, from either a thickening of irritated tendons or internal swelling which creates constant pressure.

SYMPTOMS

Symptoms don’t appear suddenly, nor with full force, but begin mildly and gradually worsen over time. Beginning symptoms include frequent burning, tingling, or numbness in the palm of your hand and fingers, and some describe their fingers as feeling useless. Symptoms often begin at night, waking you up with the need to move your wrist around to release pressure. As carpal tunnel syndrome progresses, the tingling and numbness starts to occur during in the day, not just at night. You may also experience a loss of coordination, weakness, and aches up through your forearm.

CAUSES/RISK FACTORS

Carpal tunnel syndrome rarely stems from a problem with the nerve itself, but is rather due to a combination of factors which place pressure on the median nerve. The most common causes include swelling due to an injury, diabetes, thyroid dysfunction, excess fluid due to pregnancy or menopause (causing women to have high risk), high blood pressure, and rheumatoid arthritis. Your risk also increases due to outside factors such as your job, especially those which involve repetition, gripping, or vibration.

TREATMENT

In order to diagnose carpal tunnel syndrome, your doctor will look at your history, conduct a physical exam, or use electromyography which can determine the amount of damage to the median nerve. Once a diagnosis is made, your doctor will recommend either non-operative or operative treatment, depending on how advanced it is. Non-operative treatments include wrist splints (initially worn at night), anti-inflammatories, physical therapy, cortisone injections, or avoiding tasks which provoke symptoms.

If your case is more severe, you may need a small operation to alleviate symptoms. The surgery is minimally invasive with a quick turnaround time. Your doctor will make a small incision in your palm and release your ligament, thus releasing pressure on your nerve. You will go home the same day, and return to normal activities the day after surgery, assuming all goes well. Two weeks after surgery, a doctor will remove your stitches and the nights of waking up in pain are over. This surgery is quick, easy, and most importantly, relieves your carpal tunnel symptoms.