News & Events > Understanding Carpal Tunnel Syndrome

Understanding Carpal Tunnel Syndrome

By: Jessica Peelman, MD
Hand Surgeon - Orthopedics

Are you experiencing frequent numbness or tingling in your fingers that gets worse at night or when you are driving? Is the tingling mostly in your thumb, index or middle fingers? Do you feel that you need to shake your hands out to help decrease this sensation? Is this getting worse or not improving with time? If so, you may be suffering from carpal tunnel syndrome, the most common nerve compression disorder of the upper extremities.

Carpal tunnel syndrome is named after the part of the body that it affects. The carpel tunnel is located where your hand meets your wrist and is made up of eight bones and ligaments that form a passageway of sorts. This area contains the median nerve which goes from your arm through your hand and makes sensation in your fingers possible. When the ligament that crosses over the median nerve in the area of your palm becomes tight, it can cause the median nerve below to swell. The swelling and pressure means that the median nerve is no longer able to help you feel sensation in your fingers and the pressure may lead to a feeling of numbness in your fingers.

There is no known cause for carpal tunnel syndrome and it can occur in anybody. However, there is a higher incidence of the condition in people with metabolic conditions such as diabetes and thyroid problems, or during pregnancy.

If you suspect that you may have carpal tunnel syndrome, you should seek an evaluation from a hand specialist or neurologist. The doctor may conduct tests designed to determine whether your median nerve is irritated as well as test the sensation in your fingers. These specialists may order an electromyography (a nerve study) which measures how well your nerves are working and if they are compressed. If necessary they may also use a test that will determine if electrical impulses are slowed in the carpal tunnel region.

Once a diagnosis of carpal tunnel syndrome is confirmed, the doctor may suggest some conservative treatment options including wearing a wrist brace. Many people have a tendency to curl up their wrists when they sleep which actually puts more pressure on the nerve. Wearing the brace at night can help lessen this pressure which can then help the nerve to calm and heal. Some people with mild carpal tunnel may have their symptoms go away by simply wearing the brace. However, if you have not experienced relief from your symptoms within four to six weeks, additional treatment may be warranted.

In some people, a cortisone steroid injection can help alleviate the symptoms of carpal tunnel. However, this may provide only a temporary relief and those with moderate to severe symptoms may consider surgery to address the condition.

Carpal tunnel release surgery is the most common hand surgery done today. The surgery is a short outpatient procedure in which a hand surgeon makes a small incision in your palm, and then releases the tight ligament. This opens up the carpal tunnel area which gives the median nerve more room. You may have some mild soreness in your palm for a few weeks after the surgery, but most people are able to resume their normal activities shortly after the procedure.

Surgery for carpal tunnel syndrome is an elective procedure and you may opt to try conservative treatment approaches before moving forward with the surgery. However, if you have recurring or severe carpal tunnel your doctor may urge you to consider the surgery. Severe carpal tunnel syndrome can lead to both atrophy of muscles in the hand and permanent nerve damage.

There is nothing you can do to actually prevent carpal tunnel syndrome, but there are steps you can take to lessen the symptoms or decrease the severity when you begin to experience numbness. Some people find that putting on wrist splints at night when they feel symptoms developing helps while others have had luck by adding ergonomically correct chairs, keyboards or tools to their desk.

While carpal tunnel syndrome is common, the good news is that it is completely treatable. With a proper diagnosis, care and treatment, most people can resume their normal activities and be free from the pain or tingling they were experiencing when they first sought out medical help.
For more information about carpal tunnel syndrome, please contact us at 603-778-7975.