Medical issues in the hands and wrists can be extremely limiting and frustrating. They can turn even the simplest tasks into difficult challenges, and when left untreated, lead to debilitating symptoms. The most common of these issues is carpal tunnel syndrome or CTS. In fact, according to a study by the American College of Rheumatology, somewhere between 4 and 10 million Americans live with Carpal Tunnel Syndrome today, making it the most common nerve disorder in the United States.
Defining Carpal Tunnel Syndrome
The carpal tunnel is the cavity that guides the medial nerve through the carpal bones of the wrist and into the hand. When functioning properly, the tunnel places no pressure onto the medial nerve in the wrist. Yet when excess tissue or any sort of mass or fluid builds up in the tunnel, pressure is applied to the nerve, leading to a number of negative symptoms. This is known as carpal tunnel syndrome.
The pressure applied to the medial nerve most commonly occurs through the repetitions of physical tasks with the wrists and hands–anything from typing or using a cellphone in the office, to using a nail gun or power saw on the job site. These activities can cause inflammation and swelling in the tendons which can lead to carpal tunnel syndrome. Activity is not the sole cause of carpal tunnel syndrome. A wide variety of conditions ranging from obesity, arthritis, and diabetes, to aging, pregnancy, and trauma can also lead to developing carpal tunnel syndrome. Yet despite its diverse causes, those that suffer from CTS typically experience similar symptoms.
The 3 Most Common Symptoms
Numbness and Tingling
When a nerve is damaged or compressed, as is the case with carpal tunnel syndrome, the nerves fail to communicate properly with the brain. With CTS, that means tingling throughout the first 4 digits of the hand, as well numbness throughout the thumb and wrist, and a zapping feeling in the tips of the fingers. While on their own these symptoms are relatively harmless, overtime they can prove extremely cumbersome. Feelings of numbness are especially common throughout the night, whereas tingling sensations are more commonly reported throughout the day’s activities
Pain
While those with less severe cases report little to no pain, carpal tunnel syndrome can be a significant source of pain throughout the hand’s base and the lower wrist. For some, pain can also occur in the neck and upper shoulders, as the medial nerve extends down from the upper vertebrate to the hand.
General Weakness
Carpal tunnel syndrome often leads to the loss of grip strength and a feeling of weakness and fatigue in the wrists and hands. In chronic cases, CTS can actually lead to significant atrophying of these muscles. When you combine this weakening with the first two symptoms, someone in very good health might struggle with simple tasks such as pouring a glass of milk or twisting on a water spigot.
Treatments
While carpal tunnel syndrome can create a serious burden in one’s life, a number of treatments, ranging from mild to more intensive, have proven to be effective solutions for even the most serious cases.
Nonsurgical solutions
Stretching and Splinting
Oftentimes, a regiment of stretching and exercises targeting the root of the nerve (in the spine) and the upper shoulder can lead to a relief of symptoms, even in the wrist and hand. Other stretching can work to reduce tightness and inflammation in the carpal canal itself, especially when symptoms are due to the swelling of the tendons. Another common treatment for CTS is wearing a splint on the wrist to keep it from twisting or bending, preventing any irritation of the nerve. Most wear this type of splint throughout the night, as symptoms can flare up if the wrist is strained during sleep.
Medications and Injections
Regular anti-inflammatory drugs can bring some immediate relief, but no studies have shown that they actually improve carpal tunnel syndrome. Corticosteroid injections, however, can have more lasting effects, as they directly target the inflammation with medicines like cortisone, and in many cases, substantially treat pain.
Surgical Solutions
Carpal Tunnel Release Surgery
If other treatments fail to improve CTS, release surgery may be appropriate. This simple procedure involves cutting the top ligament of the Carpal Canal in order to give the medial nerve more space, eliminating any and all pressure on the medial nerve. The surgery–which can be performed open or through endoscopy–can often provide almost immediate relief for those struggling with severe Carpal Tunnel Syndrome. And while some symptoms may persist, this procedure is by far the most effective treatment for long-lasting results.
Request an Appointment
The team at South Shore Orthopedics has expertise in a wide range of orthopedic subspecialties, including fracture care, sports injuries, and joint replacement. If you have concerns about fractures, sprains, strains, or other orthopedic injuries, call our office at (781) 337-5555 to make an appointment.
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