Carpal Tunnel Syndrome

What is it The carpal tunnel is a space in the wrist where a nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome occurs when swelling in the tunnel compresses the median nerve.

What causes it The most common misconception is that carpal tunnel syndrome is limited to people who spent a great deal of time at computers. In reality, it affects anyone who grips something tightly or uses their wrists consistently, such as cashiers, cyclists, meat cutters and musicians. Occupations that involve prolonged use of vibrating equipment, such as a jackhammer, are also prone to carpal tunnel syndrome.

A second misconception is that carpal tunnel is always work-related. It is not; age, weight, smoker status, diabetes and pregnancy are also risk factors.

Symptoms: Tingling, numbness and pain in the thumb, index and middle fingers are the most common symptoms of carpal tunnel syndrome. These symptoms are usually experienced at night, but also accompany prolonged gripping (steering wheel, newspaper, grocery or tote bags). Patients may also experience clumsiness when handling objects or a weaker grip.

Initial Evaluation: The physician will examine your hand and arm and ask you about your medical history, any injuries you may have sustained to your hand or arm, the job that you perform, hobbies or sports you participate in, etc. An x-ray or other lab tests may be performed to rule out other causes of your symptoms. The Curtis National Hand Center has a test on-site that can determine if a person has carpal tunnel syndrome. Called the NeuroMetrix NC-stat system, the system measures neuromuscular signals that are useful in the diagnosis and evaluation of nerve entrapment affecting functions of the hand. The test is painless and results are available in about five minutes. Click here for a physician referral.

Treatment: There are many non-surgical courses of treatment for carpal tunnel syndrome, such as splints or braces to immobilize and rest the wrist, adjustments to how you perform daily activities, oral anti-inflammatory medications and steroid injections. If non-surgical treatment is not successful or treatment is sought too late, surgery may be required. This surgery involves enlarging the carpal tunnel, which in turn will relieve the swelling and pressure on the nerve. This is an outpatient procedure done under local anesthesia. In severe cases, even surgery may not reverse the effects of carpal tunnel syndrome. Carpal tunnel surgery is followed by hand therapy which varies by case, but usually lasts 1-3 months.