August 8, 2017 – Pretty much anyone can get carpal tunnel syndrome.
As many as one in twenty people will have it in their lifetime. If your
fingers have numbness or tingling or if you feel a decrease in grip strength
(or keep dropping things), it’s a good time to seek medical attention.
While carpal tunnel syndrome is a common condition, many other conditions
may cause similar or confusing symptoms and must be considered in making
an accurate diagnosis, according to Michael J. Sullivan, M.D., board-certified
orthopedic surgeon, Summit Sports Medicine & Orthopaedic Surgery,
a strategic affiliate of Southeast Georgia Health System.
Women, diabetics, people with hypothyroidism or rheumatoid arthritis get
it more frequently. Pregnant women also get it with higher frequency.
Some people believe carpal tunnel syndrome is related to repetitive motion
and overuse of the hand and wrist.
“Carpal tunnel syndrome, simply put, is the cry for help of a compressed
nerve in the wrist,” said Sullivan. “This nerve is the median
nerve which may get compressed in the carpal tunnel, a bony trough in
the wrist through which the nerve and some tendons pass. The nerve expresses
its displeasure with a variety of unpleasant feelings.”
A person may feel tingling, pins and needles, decreased, or absent sensation
in the fingers. Most commonly this is felt in the index and middle fingers.
The thumb and ring finger may also be numb, individually or in combination
with the other fingers. Usually this starts at night and progresses to
daytime numbness. Some people will feel a loss of strength, have problem
gripping things, or even drop things because of their carpal tunnel syndrome.
In extreme cases people notice loss of muscle in the thumb.
“Once diagnosed, there are several ways to treat carpal tunnel syndrome,”
Sullivan said. “The main treatment is wearing a splint on the wrist
at night while sleeping. Some advocate rest if a particular activity seems
to cause symptoms. Treatment of an underlying condition which makes it
worse, like diabetes, is important. These straightforward steps provide
a cure in roughly half of patients with carpal tunnel syndrome.”
Nonsteroidal, anti-inflammatory pills and steroid injections may give temporary
relief if needed. If non-operative treatments do not provide significant
relief or cure after four to six weeks, then the option of surgery is
considered. A nerve conduction study is often performed as part of the
surgical planning process.
“Surgery for carpal tunnel syndrome is a common outpatient surgical
procedure performed under either general [fully asleep] or regional [arm
asleep] anesthesia,” Sullivan said. “Using an incision in
the palm, the roof of the carpal tunnel is divided, taking pressure off
the nerve. Sutures are placed and removed after two weeks. The skin is
usually completely healed at three weeks after surgery.”
Relief of nighttime symptoms is often immediate, according to Sullivan.
Relief of daytime symptoms can take weeks or months. In some severe cases
patients experience incomplete relief of symptoms; however, relief of
symptoms and a return to usual activity after carpal tunnel release is
a reliable and typical result for the majority of people.