Carpal Tunnel Syndrome Orthopedic Doctor
Carpal tunnel syndrome is a condition which results from one of the major nerves in the hand being compressed as it travels through the wrist. Some symptoms include numbness, tingling or weakness in the hand and arm. Loss of proprioception (knowing where your hand is in relation to your body) can also occur.
Causes:
Pressure on the median nerve causes carpal tunnel syndrome. This nerve is what gives sensation to the palm side of the thumb and fingers. Carpal tunnel syndrome is usually developed from a combination of risk factors. Repeated motions over long periods of time can irritate the tendons in the wrist, and then lead to swelling which puts pressure on the median nerve. Certain health conditions such as diabetes, rheumatoid arthritis, and thyroid gland imbalances can lead to carpal tunnel. Sprains and fractures also may put increased strain on the nerve. Another thing to note is that women are three times more likely than men to develop carpal tunnel, possibly because the passageway for the median nerve is smaller in women than it is for men.
Diagnostics:
Medical history is taken, and a physical exam of the hands, arms, shoulder and neck can distinguish if the discomfort is from daily use, or an underlying condition. Various electrophysiological tests can also be done. These include nerve condition studies, electromyogram, ultrasounds, x-rays, and MRI scans.
Treatment:
If diagnosed early, surgery may not be necessary. Nonsurgical treatments include wearing a brace or splint, non-steroidal anti-inflammatory drugs (NSAIDs), steroid injections, or changing routines that aggravate symptoms.
Surgical procedure:
The procedure for carpal tunnel is called carpal tunnel release. This surgery aims to relieve pressure on the median nerve by cutting the ligament that acts as the roof of the tunnel. The effect is increasing the size of the tunnel, and thus, decreasing pressure on the median nerve. There are two types of carpal tunnel surgery, open carpal tunnel release and endoscopic carpal tunnel release.
Open carpal tunnel release is when a doctor creates a small incision in the palm of the affected hand, and uses it as a viewpoint inside the hand and wrist. Then, the doctor will cut the transverse carpal ligament to increase the size of the tunnel.
Endoscopic carpal tunnel release is when a doctor makes one or two small incisions, called portals, and uses a camera, or endoscope, to see inside the hand and wrist. The doctor then uses a small knife inserted through the same tube the camera is attached to.
Most of our carpal tunnel surgeries are completed at Madison Memorial.
Prevention techniques:
Carpal tunnel can be prevented by proper posture and wrist position. Alternatively, employers can develop programs that are ergonomic and reduce strain on the median nerve.
Coming soon will be videos of wrist exercises to reduce carpal tunnel pain/numbness: