Hand & Elbow Surgery

Carpal Tunnel Syndrome

 

Definition:

Carpal Tunnel Syndrome, or CTS, is a condition of the wrist that can cause pain and disability. The numbness, tingling, and weakness from CTS are due to pressure on the median nerve within the wrist. This nerve carries signals between the hand and the brain. In the wrist, the median nerve and several tendons that allow the fingers to move pass through the "carpal tunnel" - a tunnel created by the carpal, or wrist, bones and other tissue. The most common cause of CTS is swelling or inflammation around the nerves and tendons, which increases the pressure within the carpal tunnel. This increased pressure affects median nerve function, causing the symptoms of CTS. CTS can be caused by an injury, an arthritis-related conditions, or repetitive work related activities.

Common Symptoms:

The symptoms of Carpal Tunnel Syndrome can cause pain, tingling, and numbness in the thumb, index, middle, and ring fingers. Pain can shoot from the hand up the arm as far as the shoulder and fingers can feel swollen. CTS can begin gradually and can affect both hands. Symptoms can be worse at night and patients can have trouble grasping objects and drop things more than usual. As pressure on the nerve progresses, it can lead to permanent nerve damage.

Diagnosis:

Early diagnosis and treatment of CTS, generally offers an excellent chance for complete recovery. A thorough medical history and physical by a physician is needed. Special tests can be helpful to confirm the diagnosis of CTS. These tests include electrodiagnostic studies such as electromyography (EMG) to assess nerve function within your arm and hand. X-rays of the hand / wrist, in addition to blood tests, are sometimes required to find out if there are any other medical problems that are causing CTS.

Treatment Options:

The goal of treatment is to relieve pain and prevent CTS from getting worse. The type of treatment depends upon the severity of your CTS. Initial treatments consist of a wrist splint to help reduce swelling and adjusting daily work activities to relieve CTS symptoms. Injectable Medications, such as cortisone injections, can often reduce the swelling that causes pressure on the median nerve. Anti-inflammatory medications can also reduce the swelling and relieve pain. Surgery is generally recommended after conservative treatment options have failed as outlined above. Surgery may be required to relieve the symptoms and prevent permanent nerve or muscle damage. The procedure is called "carpal tunnel release" and is performed on an outpatient basis. Recovery times after surgery from patient to patient, however, by 6 to 8 weeks after the operation patients generally see significant improvement in their function.