What is Carpal Tunnel Syndrome?

Do you have pain and numbness in your hands? Is your grip weakened? Do you have difficulty with buttons or putting on jewelry? Do you wake up at night with your hands in pain and numb? If you answered yes to any of these questions then you may have carpal tunnel syndrome (CTS).

CTS occurs when the median nerve is compressed at the wrist, usually resulting in pain and numbness of the thumb, index finger, and middle finger. Grip strength and dexterity are often diminished.   Symptoms are often worse at night while trying to sleep, when driving a car, or reading a book.

The precise cause of the nerve compression is usually not known, but diabetes, pregnancy, and hypothyroidism are associated with CTS.

What Can Be Done to Help?

The first step in treating CTS is to try simple measures. Avoiding activities that bring on or worsen the symptoms is the first step. Wearing a simple wrist splint at night while you sleep is often an effective way to relieve symptoms. In some situations, a cortisone injection at the wrist is helpful. In select patients, surgical decompression of the nerve is indicated to prevent further nerve damage and to attempt to restore sensation and strength and relieve pain. We advise that you seek care from your WOSM physician to determine which type of treatment is right for you.

What to Expect in your Office Visit for Carpal Tunnel Syndrome

If you make an appointment to be evaluated for CTS you should expect your office visit to be relatively quick and easy. After talking to you about your symptoms, your doctor will examine your neck and arms and test your sensation and hand strength. In some instances, your doctor may order an EMG (electromyelogram) to further assess the nerve. Occasionally, a cortisone injection into the wrist can be performed.

What if I need Surgery?

If needed, surgery is performed through an open procedure or using a less invasive endoscopic technique. The open procedure is performed under local, regional, or general anesthesia. A 2 inch incision is made in the palm, thereby releasing pressure on the median nerve.

The endoscopic procedure is performed through ½ inch incision on the wrist, and a small camera is used to look directly at the nerve and to relieve the pressure on the nerve.   Local (usually with some sedation), regional, or general anesthesia are appropriate.

Both procedures are safe and can be performed as outpatient surgery (go home the same day of surgery). You and your doctor will decide which procedure is best for you.

What to Expect After Surgery

Regardless of whether you have an open or endoscopic carpal tunnel release, you will have a soft dressing on your hand. You will be able to resume light activities with the hand the day after surgery, such as eating, hygiene activities, getting dressed, and typing. Some patients use narcotic pain medicine (prescribed by your doctor) for a day or two after surgery.   Others simply require over the counter anti-inflammatory medication or Tylenol. Elevate your hand as much as possible for the first 48 hours after surgery.

If you think you have Carpal Tunnel Syndrome, please call the physicians at WOSM now to schedule your appointment.