Carpal Tunnel Syndrome
Carpal tunnel syndrome is one of the most common causes of pain in the hand, wrist, and fingers. It is caused by compression of the median nerve in the wrist. Symptoms typically include burning, tingling, and numbness in the fingers and pain in the wrist shooting down into the fingers. The symptoms may be much worse at night or in the early morning hours and some patients wake up feeling like they need to “shake the hand out” in order to get the pain and numbness to improve.
Patients with certain conditions such as diabetes, thyroid disease, kidney disease, or hormonal changes (pregnancy or menopause for example) may experience carpal tunnel syndrome more often than others. Diagnosis is usually established with a simple physical examination and if in doubt, an electrical test of the nerves may need to be performed.
Carpal Tunnel Syndrome Treatment
Treatment usually starts with usage of wrist splints at night. The splint keeps the wrist from falling into a flexed or extended posture for hours at a time, therefore relieving some of the nerve compression that may be caused by wrist positioning. Cortisone injections into the wrist may also be useful for severe cases. In patients who still have major symptoms even after a reasonable trial of splinting and cortisone injections, carpal tunnel release will almost always take care of the problem. This is a simple 10-minute outpatient procedure that is done under local anesthesia. Open and endoscopic (“minimally invasive”) carpal tunnel releases are both equally effective, though endoscopic carpal tunnel release does leave a smaller scar and can result in faster return to work and sports. Patients are free to use the hand immediately after surgery, and most of the postoperative discomfort resolves in a few days. Patients are usually back to full manual labor two weeks after endoscopic surgery or 6 weeks after open surgery.
See a Demonstration of Endoscopic Carpal Tunnel Release