Carpal Tunnel Syndrome
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is a painful hand and wrist condition caused by compression of the median nerve as it passes through the carpal tunnel in the wrist. The carpal tunnel is a narrow passageway formed by the small bones of the wrist (carpal bones) and a ligament that runs across the wrist. Through this tunnel runs the median nerve, which provides sensation to the thumb, index, middle, and part of the ring finger, along with several tendons that control finger movement.
Carpal tunnel syndrome occurs when the median nerve becomes pinched or compressed within the carpal tunnel. The median nerve runs from the forearm to the hand through this tunnel alongside several tendons that move the fingers. When these tendons become inflamed or another irritation or obstruction is present in the carpal tunnel, the median nerve can become pinched between the obstruction and the bones of the carpal tunnel.
Several conditions can cause carpal tunnel syndrome, including diabetes, thyroid disorders, pregnancy, menopause, and arthritis. Injuries such as wrist fractures and repetitive stress to the wrist from activities like typing or using a computer mouse can also contribute to the development of carpal tunnel syndrome.
Symptoms of carpal tunnel syndrome include pain in the wrist and forearm, numbness and tingling (often described as pins and needles), or radiating pain in the palm side of the hand and fingers. These symptoms often worsen at night or during activities that involve repetitive wrist movements. If left untreated, the median nerve can become permanently damaged, resulting in weakness and muscle loss in the hand, as well as loss of coordination and sensation in the fingers.
Nonsurgical Treatments
Many cases of carpal tunnel syndrome can be effectively managed without surgery, especially when caught early. Our doctors offer a range of nonsurgical treatments to help relieve pain, reduce nerve compression, and restore hand function.
Lifestyle Modifications
Rest is essential for managing carpal tunnel syndrome. Avoiding or modifying activities that aggravate symptoms, such as repetitive wrist movements or prolonged computer use, can help reduce nerve compression. Taking frequent breaks during work, adjusting workstation ergonomics, and using proper wrist posture during activities can significantly reduce symptoms and prevent progression.
Medications & Injections
Anti-inflammatory medications can help reduce pain and swelling associated with carpal tunnel syndrome. Cold compresses applied to the wrist may also provide relief. In more persistent cases, anti-inflammatory corticosteroid injections can provide temporary relief by reducing pressure on the median nerve. Patients should talk to their pharmacist before purchasing anti-inflammatories, as these medications may be contraindicated or may interact with other medications and medical conditions.
Physical & Occupational Therapy
Physical and occupational therapy play important roles in treating carpal tunnel syndrome. Therapists can provide exercises to improve flexibility and strength in the hand and wrist as well as nerve gliding exercises to help the median nerve move more freely through the carpal tunnel. Occupational therapy includes ergonomic evaluation and education on proper techniques for daily activities to minimize strain on the wrist.
Supportive & Assistive Devices
Splinting the wrist, particularly at night, is one of the most effective nonsurgical treatments for carpal tunnel syndrome. A wrist splint keeps the wrist in a neutral position, reducing pressure on the median nerve and allowing it to rest and recover. Many patients experience significant symptom relief with consistent splint use.
Surgical Treatments
When nonsurgical options are no longer effective and symptoms persist or worsen, surgery may offer lasting relief and restored hand function. The right surgical approach depends on the severity of nerve compression and your individual circumstances.
Carpal Tunnel Release Surgery
If symptoms do not improve with conservative treatment, outpatient carpal tunnel release surgery to decompress the carpal tunnel is usually necessary to permanently relieve symptoms and restore hand functionality. The procedure involves cutting the ligament that forms the roof of the carpal tunnel, creating more space for the median nerve and relieving pressure. This surgery can be performed through a traditional open incision or using an endoscopic approach with smaller incisions. Most patients experience significant improvement in symptoms following surgery, with full recovery typically occurring over several weeks to months.