Hand & Upper Extremity Center 

What are the Signs of Carpal Tunnel Syndrome?

If you experience numbness, weakness or tingling in your hands, you may be feeling signs of carpal tunnel syndrome.  This should prompt you to schedule an appointment with your local orthopedic hand surgeon as soon as possible.  Like many ergonomic injuries, early medical intervention may prevent a more serious health condition that may require more extreme and costly treatments later.

Carpal Tunnel Syndrome is a condition is well understood by orthopedic hand surgeons.  Your wrist has a variety of bones, tendons and nerves, but it is the median nerve, which controls the fingers and passes through the carpal tunnel, that is injured with this condition.  A tendon that attaches to the base of the thumb traverses the carpal tunnel.  If the hand is positioned incorrectly repeatedly, this tendon may become inflamed and press on the median nerve, causing pain and other neurological symptoms.

What are the Treatments for Carpal Tunnel Syndrome?

There are a couple available treatment options for carpal tunnel syndrome in the early stages of the condition. 

• Wrist brace - One treatment for mild to severe carpal tunnel syndrome is splinting.  You may find wrist splints in local drug stores or your orthopedic hand surgeon may prescribe one for you. Follow your doctor’s directions regarding how long you should wear the splint each day; in some cases, your doctor may recommend that you wear it even while asleep.

• NSAIDs – A nonsteroidal anti-inflammatory drug or NSAID may help alleviate some of the pain and inflammation that accompanies carpal tunnel syndrome, but drugs like Advil and Motrin do not improve the underlying health issue.

• Corticosteroids - A stronger anti-inflammatory treatment would be a corticosteroid like cortisone.  This more effective steroid therapy would be administered through an injection.

When should Surgery be Considered for Carpal Tunnel Syndrome?

If your symptoms continue for six months or longer, or worsen even if you are on more conservative treatments, then your doctor may recommend that you consider surgery to correct the condition. The primary option for surgical treatment is the following:

• Open surgery involves a two-inch incision that allows the surgeon to cut the transverse carpal ligament. This incision enlarges the carpal tunnel and decompresses the median nerve.

In almost all cases, the surgery is performed on an outpatient basis, meaning you should be able to return home that day. Your wrist will be bandaged and splinted for one or two weeks to prevent re-opening the incisions and allow for healing.  Your doctor may also direct you to keep your hand elevated—even while sleeping—to limit swelling. Pain symptoms can be managed with medications.

Following the procedure, your doctor will then set up an appointment with an occupational therapist. An occupational therapy program should help expedite healing and re-instill natural wrist mobility.  It may take days or months to fully recover from carpal tunnel release surgery, depending on how long your median nerve has been compressed.