In short,
- Carpal tunnel syndrome treatment aims to relieve pressure on the median nerve.
- Non-surgical options often help those with mild to moderate carpal tunnel syndrome.
- It’s best to consult a doctor to determine the best carpal tunnel treatment plan for you.
Carpal tunnel syndrome (often called CTS) treatment options are available and can help reduce pressure and pain, but requires the attention of a skilled doctor. It occurs when the median nerve, which runs from your forearm into your hand, becomes compressed at the wrist within the carpal tunnel.
Understanding Carpal Tunnel Syndrome
The carpal tunnel is a narrow passageway on the palm side of your wrist, formed by bones and ligaments. The median nerve provides sensation to the thumb, index, middle, and part of the ring finger, and controls some muscles at the base of the thumb.
Compression of this nerve leads to pain, numbness, tingling, and weakness in the hand and wrist, impacting a person’s ability to perform everyday tasks.
Prevalence and Impact of Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common condition, affecting approximately 1% to 5% of adults according to the CDC. The condition can significantly impair daily activities, work performance, and overall quality of life, making tasks like typing or holding objects difficult.
The economic impact of CTS is substantial due to lost workdays and healthcare costs.
Causes and Risk Factors for Carpal Tunnel Syndrome
The most common causes and risk factors for CTS are:
Anatomical Factors Contributing to CTS
A smaller carpal tunnel or variations in wrist anatomy, such as bone spurs or cysts, can predispose individuals to median nerve compression. Swelling or inflammation within the carpal tunnel also increases pressure on the median nerve.
This swelling can be caused by repetitive motions, trauma, or underlying medical conditions.
Medical Conditions and Carpal Tunnel Syndrome
- Certain medical conditions, such as diabetes, rheumatoid arthritis, and hypothyroidism, can increase the risk of CTS.
- Diabetes can damage nerves, rheumatoid arthritis causes joint inflammation, and hypothyroidism can cause fluid retention, all contributing to carpal tunnel swelling.
- Obesity and pregnancy are also associated with an increased risk.
Lifestyle and Occupational Risk Factors
Repetitive hand and wrist movements, especially forceful gripping, can contribute to CTS, particularly in jobs that require assembly line work, typing, or using hand tools. Prolonged use of vibrating tools and poor posture can exacerbate carpal tunnel symptoms.
Maintaining a neutral wrist position while working is crucial to preventing excessive strain on the median nerve.
Recognizing Carpal Tunnel Syndrome Symptoms
The early and progressive symptoms of CTS are:
What are the Early Warning Signs of CTS?
Early symptoms of carpal tunnel syndrome include:
- Numbness or tingling in the fingers (thumb, index, middle, and part of the ring finger), especially at night, often due to wrist position during sleep.
- Pain that radiates from the wrist up the arm and weakness in the hand, making it difficult to grip objects, are also common early indicators.
Progressive Symptoms of Carpal Tunnel Syndrome
As CTS progresses, symptoms can include decreased grip strength and difficulty performing fine motor tasks, such as buttoning clothes or writing. Muscle atrophy at the base of the thumb (thenar eminence) and loss of sensation in the affected fingers can also occur, indicating long-standing nerve compression.
When to Seek Medical Attention for CTS Symptoms
Seek medical attention for persistent or worsening symptoms that interfere with daily activities, symptoms that do not improve with home remedies, or sudden onset of severe pain or weakness in the hand. Early diagnosis and treatment can help prevent permanent nerve damage and loss of function.
Diagnosis and Testing for Carpal Tunnel Syndrome
CTS diagnosis and testing include:
Physical Examination for CTS
Diagnosis begins with a physical exam where the doctor will assess your symptoms and medical history, asking about the onset, duration, and severity of your symptoms. Phalen’s test (holding wrists flexed together) and Tinel’s sign (tapping over the median nerve at the wrist) may be performed to reproduce symptoms, suggesting median nerve compression.
Nerve Conduction Studies (NCS) and Electromyography (EMG)
NCS measures the speed of electrical signals traveling through the median nerve to determine the severity of nerve compression and differentiate CTS from other nerve disorders. EMG assesses the electrical activity of muscles controlled by the median nerve to identify muscle damage caused by nerve compression and is often performed with NCS.
A slower conduction velocity or abnormal electrical activity indicates nerve damage.
Carpal Tunnel Syndrome Treatment Options
CTS treatment options include:
Non-Surgical Carpal Tunnel Syndrome Treatment
Non-surgical treatments are often the first line of defense for mild to moderate CTS. These include wrist splints worn at night, corticosteroid injections to reduce inflammation, and physical therapy with exercises to improve wrist and hand strength and flexibility.
Surgical Carpal Tunnel Syndrome Operation
Carpal tunnel release surgery involves cutting the carpal ligament to relieve pressure on the median nerve. According to the National Institutes of Health, surgery has a success rate of somewhere between 75% and 90% improvement in patients.
Options include:
- Open carpal tunnel release (traditional with a larger incision) and endoscopic carpal tunnel release (minimally invasive with smaller incisions).
- Endoscopic surgery typically results in less pain and a faster recovery time compared to open surgery.
Post-Operative Care and Rehabilitation After Carpal Tunnel Syndrome Operation
Post-operative care includes hand therapy to regain strength and range of motion, scar management to prevent stiffness and pain, and a gradual return to activities, avoiding repetitive motions and heavy lifting initially. Full recovery from carpal tunnel release surgery can take several weeks to months.
Prevention and Lifestyle Changes for Carpal Tunnel Syndrome
CTS prevention strategies are:
Ergonomic Adjustments to Reduce CTS Risk
Preventative measures include proper workstation setup with keyboard and mouse placement to maintain a neutral wrist position, the use of ergonomic tools like wrist rests, and regular breaks to stretch and move hands and wrists.
The keyboard should be positioned so that the elbows are at a 90-degree angle and the wrists are straight.
Exercises and Stretches for Carpal Tunnel Syndrome
Exercises to help prevent CTS include wrist extension and flexion exercises to improve flexibility, tendon gliding exercises to promote nerve mobility, and hand strengthening exercises to improve grip strength.
Lifestyle Modifications to Manage CTS
Lifestyle modifications include maintaining a healthy weight to reduce overall inflammation, managing underlying medical conditions such as diabetes and arthritis, and avoiding activities that aggravate symptoms.
When to Seek Carpal Tunnel Syndrome Treatment in Miami Lakes & Plantation, FL
Seek treatment if numbness, tingling, or pain persists despite home remedies, or if symptoms interfere with daily activities or sleep. Also seek medical attention if you experience weakness in your hand or difficulty gripping objects, or if you notice muscle atrophy at the base of your thumb.
Call us today at (954) 635-5300 or use our online appointment request form. The team at The Orthopaedic Hand and Arm Center provides comprehensive evaluations and is committed to helping to work toward a pain-free lifestyle.
