Conditions We Treat

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common cause for pain, numbness, and tingling in the hand. It is caused by compression of the median nerve as it travels through the wrist and affects between four and ten million people in the U.S., with women at least twice as likely to be affected as men.

person holding wrist - carpal tunnel syndrome - APSM

What Is Carpal Tunnel Syndrome?

What causes carpal tunnel syndrome?

The median nerve brings feeling to the palm side of your thumb and first three fingers (not the pinkie). It also helps to control some movements. Over time, any compression of this median nerve can cause carpal tunnel syndrome.

Common causes and risk factors for this condition include:

  • Repetitive use from such activities as driving, reading, typing, and holding a telephone
  • Wrist fracture and associated swelling
  • Pregnancy or oral contraceptive use that leads to swelling in the limbs
  • Underlying nerve dysfunctions

Two conditions that can cause irritation in the tendons of the wrist that compress the median nerve can be rheumatoid arthritis and diabetes, even without injury or repetitive motions.

What are the symptoms of Carpal Tunnel Syndrome?

Pain, numbness, and tingling usually occur on the palm and palmar side of the first three fingers from the thumb. Weakness can occur in the thumb and adjacent fingers.

These symptoms usually occur at night, depending on the position of the wrist, and may radiate up the arm as far as the shoulder.

Other symptoms can include:

  • Decreased dexterity
  • A weak grip
  • Atrophy of muscles in the hand
  • Feelings of hand swelling

What are my treatment options for Carpal Tunnel Syndrome?

The goals of carpal tunnel treatment are to reduce pain, numbness, and tingling, and to prevent further loss of motor function. Treatment options are plentiful, but depend on the severity of your symptoms and your lifestyle.

You can treat most mild to moderate cases with a combination of conservative treatments.

In general, these are the at-home carpal tunnel syndrome treatments that can help:

  1. Minimize contributory factors such as repetitive use and strain
  2. Use a splint to keep the wrist in a neutral position, when possible
  3. Limit prolonged extension and flexion
  4. Stretch hands, wrists, and arms regularly
  5. Use ergonomic office tools to prevent irritation

Interventional treatments

Steroids (orally or injected into the carpal tunnel) to reduce inflammation and compression can be utilized when conservative treatments are ineffective.

Carpal tunnel syndrome surgery

If symptoms do not improve within 6 months of conservative or minimally-invasive therapy, the next step for moderate or severe carpal tunnel syndrome is surgical decompression of the median nerve. Surgical intervention is generally more effective than conservative treatments, especially for moderate to severe cases.

The outlook for carpal tunnel syndrome surgery is good, although some patients, particularly those with advanced carpal tunnel syndrome, may experience little to no improvement after the procedure.

Post-surgical scarring can lead to a recurrence of symptoms several months or years later. The most effective treatment for carpal tunnel is to prevent it altogether by protecting your wrists and hands from repetitive motion injury.

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Common Conditions We Treat