Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
On the palm side of the wrist is a passageway, called the carpal tunnel. There are very small bones in the wrists that form it on the sides. There are connective tissues and ligaments, known as the transverse carpal ligament, which holds it in place. The flexor tendons are located within the carpal tunnel. This is what allows you to bend and move your fingers. The sensations that allow you to feel in your hands and fingers are the result of the nerves found here.
The tissues located around the tendons help to lubricate the wrist. This is why it is able to move smoothly with the fingers. When a person has Carpal Tunnel Syndrome, there is swelling and that results in the nerves being pinched. The ligaments become tight and narrow. This puts pressure on the nerves.
Signs & Symptoms
Should you experience any of the symptoms of Carpal Tunnel Syndrome, you should talk to your doctor right away for further evaluation. Some of the common symptoms include numbness and tingling of the fingers. There may be pain or a burning sensation in the wrist and the hand. It can be bad enough to radiate to the arm and the elbow.
Reduced ability to grip is often noticed as one of the early signs. Decreased sensations to touch with the fingers is also noticed. Typically, any of these symptoms a person experiences will be worse for them at night.
Some of the common symptoms associated with Carpal Tunnel Syndrome include
- Numbness and tingling in the thumb, index, and middle fingers
- Pain and burning in the hand and wrist that may radiate up the arm to the elbow
- Decreased sensation and weakness in the hand with diminished grip strength
- Worsening of symptoms at night
Causes of Carpal Tunnel Syndrome
Some individuals have a higher risk of experiencing Carpal Tunnel Syndrome. Individuals who take part in repetitive tasks day after day tend to be at the top of the list. This can include typing, machine work, and gripping for long periods of time. Sometimes, trauma to the wrist can create this type of concern due to a fracture or sprain.
- Repetitive Motion: performing heavy, repetitive hand and wrist movements with prolonged gripping at work or play
- Congenital: Some people are born with narrower carpal tunnel canals.
- Trauma: Injury to the wrist such as fractures or sprains.
- Hormonal Changes: Pregnancy, menopause, birth control pills or hormone pills are risk factors as they alter the levels of hormone in the body.
- Medical Conditions: Conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, gout, overactive pituitary gland, or the presence of a cyst or tumor extending to the carpal tunnel
Your doctor will need to review your medical history and conduct various tests to determine if you have Carpal Tunnel Syndrome. Some of the tests that could be requested include a blood work panel, x-ray, and electro diagnostic testing. The blood work can help to rule out thyroid issues or arthritis. The electro diagnostic test will help to determine the electrical current activity in the muscles and nerves.
If the diagnosis is confirmed to be Carpal Tunnel Syndrome, your doctor will try various treatments for you to benefit from. If you have arthritis or diabetes, those underlying issues have to be addressed as well with the treatment. You may have your wrist immobilized with the use of a brace for several weeks. Icing the area several times per day can help to reduce swelling.
Avoid activities that are likely to have triggered the symptoms in the first place. This may be mean changing your hobbies or taking time off from your job. If you have a great deal of pain, medication may be prescribed to help with reducing it. Physical therapy may be recommended to help make the wrist more flexible and stronger.
Should such treatment methods not work or not do enough to reduce the problem, your doctor may recommend Carpal Tunnel Syndrome surgery.
Carpal Tunnel Release Surgery
When carpal tunnel can’t be successfully treated with therapy and other procedures, surgery may be the next option to consider. This type of procedure is simple enough, and most patients are able to go home the same day. This is called an endoscopic surgery. A tube with a small camera attached to it will be entered into the wrist through a small incision or a couple of incisions. There is a video monitor that the doctor looks at to see what the camera is able to see.
This allows the internal elements of the wrist to be viewed and evaluated. Once the ligament is found, a cutting tool is used to release it. The result of this is the pressure on the nerves is reduces and the symptoms a person has been experiencing will start to lessen immediately. Once the surgery is competed, a few stitches are put in place to close the incisions. The ligament will take some time to heal.
Patient having carpal tunnel release surgery can be discharged home the same day. Your surgeon will suggest certain post-operative procedures for a better recovery and to avoid complications.
- Elevate the hand above heart level to reduce swelling
- A splint may be worn
- Ice packs to the surgical area to reduce swelling
- Keep the surgical incision clean and dry; cover the area with plastic wrap when bathing or showering
- Physical therapy may be ordered to restore wrist strength
- Eating a healthy diet and not smoking will promote healing
Most patients are able to complete the Carpal Tunnel surgery process without any complications. However, there are some possible risks to be aware of before you go through the procedure. Some individuals will continue to experience pain, infections, scarring, and nerve damage causing continued issue in the hand and wrist area.
Proudly serving patients across New Jersey and Bergen County from our office in Hackensack. Whether you are in Jersey City, Rutherford, Garfield, Lodi, Ridgewood, Nutley, or Englewood, NJ, we look forward to addressing your questions and providing you with the treatment you need.