Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) is a condition where pressure that develops at the wrist causing pressure on the Median Nerve. This can result in pain, paresthesias/tingling/numbness in the fingers, and in severe cases weakness in the hand. Often in early cases patients have intermittent numbness in their fingers that can wake patients up at night or occur with certain activities.
In patients with mild symptoms that have been present for a short duration (several months or shorter) wearing a carpal tunnel brace can help alleviate the symptoms. A carpal tunnel brace is a wrist support that is intended to be worn at night that splints the wrist straight to take pressure off the carpal tunnel and median nerve at the wrist. In patients with symptoms for a longer duration (over several months to a year) or more severe symptoms (such as constant numbness or weakness) they may be less successful in alleviating their symptoms with carpal tunnel splinting. In these cases patient is should seek a healthcare provider to discuss further options.
Often a nerve test is ordered by health care providers and can be helpful to confirm the diagnosis with carpal tunnel syndrome and also assess the severity. A nerve test is a simple office procedure that uses electrodes to assess the nerve conduction. When there is nerve slowing or conduction block this can be indicative of moderate to severe carpal tunnel syndrome that would benefit from carpal tunnel release. Carpal tunnel injections in which a steroid injection is placed in the carpal tunnel are an option, however these typically only provide temporary relief.
Carpal tunnel release is a minor surgery that is performed in the office or in a surgical center under local anesthesia or sedation. Traditionally open carpal tunnel release is performed with a 1-2 cm incision in the palm through which the surgeon then cuts the transverse carpal ligament to take pressure off the median nerve. Endoscopic carpal tunnel release is a minimally invasive technique in which a small incision is made just before the wrist to allow insertion of the endoscope (camera) into the carpal tunnel, then the transverse carpal tunnel ligament is cut from its undersurface. This can expedite recovery by avoiding an incision in the palm with the same long term results as traditional open carpal tunnel release. When carpal tunnel syndrome is addressed in the mild to moderate stages results are typically excellent with complete relief of patient’s symptoms. In cases of severe carpal tunnel syndrome in which patients have had chronic symptoms with constant numbness and weakness it is still a minor surgery and recovery but results of nerve recovery can very.
Overall carpal tunnel syndrome is a common and treatable condition that patient should discussed with their healthcare provider if they are experiencing symptoms.
