Carpal Tunnel Syndrome
What is carpal tunnel syndrome?
Carpal Tunnel Syndrome (CTS) is a common problem that affects the hand, wrist and fingers. This condition occurs when there is increased pressure on the median nerve at the wrist.
The median nerve travels from the forearm into the hand through a tunnel in the wrist the carpal tunnel. Wrist bones form the bottom and sides of the tunnel, and a ligament covers the top. This tunnel also contains nine tendons.
CTS results when increased pressure within the carpal tunnel squeezes the median nerve, eventually affecting the function of the nerve.
Symptoms of CTS:
- Numbness and tingling in the hand at night or after use.
- Aching or pain that may radiate up the forearm towards the shoulder.
- A feeling of "poor circulation" in the hands.
- Clumsiness or weakness handling objects.
Causes of CTS:
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Causes of CTS include anything that prompts swelling of the tendons or decreases the space in the carpal tunnel, such as, repetitive use of the hand and wrist or regular use of vibrating instruments. Other causes may include:
- Fractures (broken bones in the hand or wrist)
- Arthritis
- Thyroid disease
- Diabetes
- Pregnancy
Diagnosis:
A diagnosis of CTS may be confirmed following a physical examination, an x-ray and an EMG (electromyography), which tests nerve and muscle function. An NCS (nerve conduction study) may also be ordered to determine severity of the condition.
Treatment Options:
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Treatment depends on the severity of the condition and may include:
- Wearing a wrist splint to keep the wrist from bending.
- Non-steroidal anti-inflammatory medications to decrease swelling, relieving pressure and reducing pain.
- A small cortisone injection into the carpal tunnel to decrease inflammation.
If these conservative measures fail to control symptoms, a carpal tunnel release may be required in order to reduce the pressure on the median nerve and prevent irreversible damage.
Dr. Rosen offers his patients the option of an endoscopic carpal tunnel release or a mini open carpal tunnel release. Both surgeries are performed as outpatient procedures.