Carpal Tunnel Syndrome
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Carpal tunnel syndrome is a nerve disorder of the hand, caused by compression of the median nerve. The median nerve gets squeezed inside a narrow passage in the wrist called the carpal tunnel. This nerve provides feeling to the thumb, index and middle fingers and half of the ring finger.
The narrowing may be caused by:
- Injury
- Genetics
- Overuse and repetition
- Hormone-related conditions
- Tumors (rare)
Carpal Tunnel Treatment
Orthopedic surgeon A. Rashard Dacus, MD, explains the symptoms, causes and treatments of this common disorder.
Angelo Dacus:
Carpal tunnel syndrome is probably one of the most common things we see in hand surgery. And to be honest, one of the most common things that's out there in America. It's basically a compression of a nerve in the wrist and that nerve is called the median nerve. And so it runs in the middle of the hand and it gives innovation to the thumb index and the long finger. So when you have pressure on that nerve people get symptoms such as numbness and tingling. At night times, waking-ness. Numbness when they drive. Feeling of achiness and sometimes shooting pains into the fingers.
Angelo Dacus:
Risk factors for carpal tunnel syndrome tend to revolve around things that are more systemic in nature. So things like diabetes, inflammatory stuff like rheumatoid arthritis can give people propensity for it. Vibratory activities such as using a jack hammer or a chainsaw. If you're doing repetitive activities with the wrist. Typing isn't directly correlated with it but we do see a percentage of people who do have worsening symptoms with typing. There are some times that people will get it from trauma. So if you were to have a fall and break your wrist, you can get numbness in carpal tunnel.
Angelo Dacus:
So in general, we recommend that people see a physician for hand numbness when that numbness has become consistent. So one to two days of hand numbness isn't particularly that concerning, but when it becomes weeks to months, we're definitely concerned. We also recommend if it's getting worse, if you're having nighttime symptoms that really get in the way of your ability to perform your daily activities. Or if it's limiting your ability to be able to grip and hold things in a manner which you feel comfortable. Those are things in particular we recommend going to see a physician for.
Symptoms of Carpal Tunnel
Carpal tunnel syndrome causes symptoms in one or both hands or wrists. Symptoms may include:
- Tingling, burning or numbness, especially in your thumb and index or middle fingers
- Pain or numbness that worsens with:
- Wrist, hand or finger movement
- Sleep (symptoms may wake you)
- Hand stiffness or cramping that gets better after:
- Shaking your hand
- Waking up in the morning
- Weakness or clumsiness of your hand:
- Loss of grip strength
- Difficulty making a fist
- Frequently dropping things
- Pain that moves up your arm
Diagnosis & Treatment
Your doctor will look for signs of nerve irritation or damage.
Other tests may include:
- Electrodiagnostic exam
- MRI scan
- X-ray
- Ultrasound
Simple Adjustments
Sometimes making simple changes in your workplace or home may help relieve symptoms. You might also benefit from pain relievers or cortisone injections.
Wrist Splint
A splint prevents extreme movements of the wrist. It's most effective when worn at night. It can help you avoid waking up with symptoms.
Surgery
If you have severe symptoms, you may need carpal tunnel release.