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Hoag Orthopedic Physicians |
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JointWorks
Hand & Wrist
Carpal Tunnel Syndrome
The carpal tunnel is a narrow, rigid passageway of ligament and bones at the wrist through which eight flexor tendons and the median nerve pass. Carpal tunnel syndrome develops when the median nerve, which runs from the forearm into the hand, becomes compressed within this tunnel. The median nerve transmits sensory impulses from the thumb, index, middle and ring finger and also innervates the small muscles in the thumb that coordinate its movement. In some cases, inflamed tendons or other swelling within the carpal tunnel compress the median nerve. This results in pain, weakness or numbness in the hand and wrist that occasionally radiates up the arm. Though other medical conditions can cause these symptoms, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed or traumatized.
Signs and symptoms of carpal tunnel syndrome:
- Burning, tingling or numbness in the palm and fingers (particularly the thumb, index and middle fingers)
- Fingers feeling swollen with no apparent swelling
- Desire to "shake out" discomfort in hand or wrist, especially in the early morning
- Decrease in grip strength with difficulty grasping small objects
Treatment options usually begin with:
- Nighttime use of a wrist splint
- Anti-inflammatory medications that help to relieve swelling and decrease pain and numbness
- Corticosteroid injections into the carpal tunnel that reduce swelling and relieve symptoms
- Exercise programs, often supervised by a trained physical or occupational therapist, involving stretching and strengthening once symptoms have subsided
If the patient's symptoms fail to respond to these non-operative measures, surgery may be indicated. Carpal tunnel release surgery can be performed with the traditional open technique or endoscopically.
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