Carpal Tunnel Syndrome
What is carpal tunnel syndrome?
Carpal tunnel syndrome is a common, painful, progressive condition that is caused by the compression of the median nerve at the wrist area.
Symptoms of carpal tunnel syndrome
Common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except the little finger; pain and burning sensation in the hand and wrist that may radiate up the arm and elbow; and weakness in the hand, with diminished grip strength.
Causes of carpal tunnel syndrome
The exact causes of the condition are not known. However, certain factors increase the risk of developing carpal tunnel syndrome: they include congenital abnormalities, repetitive motion of hand and wrists, fractures and sprains, hormonal imbalance, and other medical conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, gout, overactive pituitary gland, or the presence of a cyst or tumour in the canal.
Conservative treatment options for carpal tunnel syndrome
Carpal tunnel syndrome may be treated using conservative approaches or surgery. The conservative treatments include:
- Treating the underlying medical conditions
- Immobilisation of the hand and wrist with a splint or wrist brace for 4-6 weeks
- Resting the hand for 2 weeks or more
- Application of ice packs to avoid swelling
- Avoiding activities that tend to worsen the symptoms
- Medications such as non-steroidal anti-inflammatory drugs and steroid injections
- Strengthening and stretching exercises once symptoms diminish
Surgery for carpal tunnel syndrome
If conservative treatment options fail to resolve the condition your surgeon may recommend surgical procedure.
Carpal tunnel release surgery
Carpal tunnel syndrome can be treated with carpal tunnel release surgery. Traditional surgery involves an incision in the palm and wrist area of up to 2 inches; whereas, endoscopic surgery involves one or two half-an-inch incisions and the use of an endoscope. During the surgery, the transverse carpal ligament will be dissected to release the pressure on the median nerve and enlarge the carpal tunnel. Your surgeon will decide which options are best for you based on your general and medical conditions.
Your surgeon may suggest you practice certain post-operative procedures for better recovery and to avoid further complications.
- Elevate the hand above heart level to reduce swelling.
- A splint may be worn.
- Apply ice packs to the surgical area to reduce swelling.
- Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering.
- Physical therapy may be ordered to restore wrist strength.
- Eat a healthy diet and do not smoke to promote healing.
Risks and Complications
Most patients suffer no complications following carpal tunnel release surgery. However, some patients may suffer from pain, infections, scarring, and nerve damage, causing weakness, paralysis, or loss of sensation and stiffness in the hand and wrist area.