Carpal Tunnel Syndrome

By Dr. Kevin W. Lanighan

What Is It?

Carpal tunnel syndrome (CTS) is the most common compression neuropathy in the upper extremity. It is estimated to affect 1% of the general population and 10% of those over 40 years old.

This pinched nerve in the wrist causes numbness, tingling, pain and weakness in the hand. If you have been awakened with a “pins and needles” feeling in your arm and hand or have experienced this sensation during the day, you likely have CTS.

Fortunately, this condition is treatable. Like most problems, if it is ignored it may worsen and cause permanent nerve damage, making future treatment less successful.

What Causes It?

The median nerve provides feeling to your hand. To reach your fingers, the nerve must pass through the carpal (which means wrist) tunnel, where it may be compressed. When the nerve gets squeezed, your hand feels like it is asleep. Your hand may feel clumsy and ache. There may be pressure on the nerve because the structures in the carpal tunnel are swollen. This can be from normal wear and tear, or fluid retention, such as in pregnancy. Previous injury or arthritis can narrow the carpal tunnel leaving less room for the nerve. Certain medical illnesses such as diabetes, rheumatoid arthritis, or thyroid problems may increase your risk for developing CTS.

What Can I Do?

If your work or hobbies involve repetitive use of your hands, you may be at risk. Keeping your wrist straight and minimizing repetitive activities may help. If you already have symptoms, your doctor may suggest a splint to protect your wrist.

Medications such as anti-inflammatory drugs may be used to reduce the swelling. Nerve studies are sometimes used to confirm the diagnosis. Occasionally these treatments are ineffective and outpatient surgery is performed to prevent permanent nerve damage. This may be done by an open carpal tunnel release through an incision in your palm.

Recently, endoscopic techniques (camera assisted) have been used in the wrist to allow a carpal tunnel release to be performed through a smaller incision in your wrist. Recovery is variable, but is generally from a few weeks to a few months. Together, you and your doctor can decide which treatment is best for your particular situation.

This information is intended for education of the reader about medical conditions and current treatments. It is not a substitute for examination, diagnosis, and care provided by your physician or a licensed healthcare provider. If you believe that you, your child, or someone you know has the condition described above, please see your healthcare provider. Do not attempt to treat yourself or anyone else without proper medical attention.