One of the most common conditions of the hand or wrist is known as carpal tunnel syndrome. This condition is centered within the nerves in the wrist. Running through the center of the wrist into the hand is a nerve called the median nerve. If this nerve becomes squeezed or compressed in any way, it can cause pain and tingling through the hand and arm. There are various causes of carpal tunnel syndrome, and several treatment options available.
Symptoms of Carpal Tunnel
The main characterizing symptom of carpal tunnel is tingling, specifically in the thumb and fingers. This can also be described as a burning or a numbness. Many people feel the need to shake their hands and massage them to try to regain feeling. It is also common to experience weakness in the hand, wrist or fingers. This can lead to dropping things or being unable to grasp things firmly, as well as loss of fine motor skills. Other symptoms include pain in the arm and shock-like sensations.
Causes of Carpal Tunnel
Generally it is difficult to find a specific cause for carpal tunnel syndrome. There is evidence that repeated motions with the wrist, like piano playing or hammering nails every day can be a cause. Another cause may be hereditary development of the arm and hand that can make it easier to accidentally crush the median nerve. Sometimes pregnancy can cause carpal tunnel syndrome. Another cause could be conditions that affect the nerves like diabetes, rheumatoid arthritis, and thyroid imbalance.
Diagnosis of Carpal Tunnel Syndrome
Although the cause of carpal tunnel may be difficult to pinpoint, it is generally easy to identify. Most doctors start with a physical examination which includes asking questions and handling the hand and wrist while applying slight pressure. They may press or tap on the median nerve and examine the wrist. They may also order some tests for you to take an inside look at the nerves.
One test a doctor might use to determine if a patient has carpal tunnel is ultrasound. Ultrasound is used to look at the veins, nerves, and bones inside a patient’s wrist. Unfortunately, an ultrasound may not be as clear, so a doctor may try other tests before a diagnosis can be made.
An EMG is a test that can help a doctor know if a patient’s nerves are working properly or are damaged in any way. It measures electrical activity through small needles and should not be painful for the patient. Through an EMG, the doctor can find out if the median nerve is working properly and if the electrical signals are travelling to the hand or not.
Through an MRI, the doctor can get a clear image of the median nerve to find out if it has been compressed by bones or swelling.
Because the severity of carpal tunnel syndrome varies greatly, there are several options available for consideration. Sometimes doctors may recommend a mild treatment but if it does not work, they may move forward to more invasive procedures.
One of the most common treatments for mild carpal tunnel is to wear a brace that stabilizes the wrist. This will most likely be worn at night as well to avoid extending the wrists while sleeping. Another option is nerve gliding exercises, which are a form of physical therapy. Some patients also benefit from cortisone steroid injections that can help reduce swelling that compresses the nerve.
Surgery for the hand or wrist is complicated but usually heals relatively quickly. The main surgical procedure for carpal tunnel is known as carpal tunnel release. There is a ligament in the wrist that presses down on the median nerve that holds it into place. This is called the transverse carpal ligament, and it goes across the wrist like a bracelet. During the surgery, this ligament is divided to give more room to the median nerve so it can expand. This is considered a long-term treatment and cure for carpal tunnel syndrome.
Make an Appointment
If you are experiencing these symptoms and think you may have carpal tunnel syndrome, contact our office to schedule an appointment! Carpal tunnel can become worse without treatment and can be very painful and uncomfortable. The treatments available are usually mild and if surgery is required, recovery time is minimal. We want to help you regain your everyday function and enjoy a healthy life!