Carpal Tunnel Syndrome


Understanding Carpal Tunnel Syndrome

The wrist is a joint with multiple bones, tendons, and nerves that connects the arm to the hand. There are multiple nerves that go to the hand, one of which is the median nerve. This nerve is commonly compressed in the carpal tunnel, causing pain, numbness, and weakness in the hand.

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  • Pain and tenderness over the wrist.
  • Numbness and tingling in the thumb, pointer, and middle finger
  • Weakness with your grip
  • Atrophy in certain hand muscles

When to Seek Treatment

If you’re noticing symptoms associated with Carpal Tunnel Syndrome and suspect an issue, it’s crucial to consider consulting a board-certified specialist in order to obtain an accurate diagnosis and timely treatment. Early intervention can significantly improve your overall well-being and provide a broader range of treatment options, which may decrease as symptoms persist. The key to a successful and speedy recovery lies in addressing the root of the pain with your specialist as soon as symptoms arise.

While many people experience day-to-day pain, dismissing it as soreness, this may not be the case for everyone. If your pain persists for more than 10 days, it should be taken more seriously. Evaluate such prolonged pain with a specialist to identify the root issue and determine the appropriate treatment. Additionally, be attentive to other signs related to pain that should not be ignored, including pain accompanied by fever, pain associated with loss of bladder control, and weakness/tingling/numbness in your arms or legs.

It’s important to note that these are general guidelines based on our expertise over the past three decades, recognizing that each patient’s symptoms may be unique.

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Common Causes

Carpal tunnel can occur for a variety of reasons:

  • Decreased space in the carpal tunnel, impinging on the nerve (for many reasons)
  • Repetitive gripping and use of the muscles that go through the wrist.
  • Wrist dislocation, fracture, or other injury
  • Significant wrist arthritis
  • Certain systemic diseases affecting nerves

Risk Factors

  • History of injury to the wrist
  • Systemic diseases like diabetes
  • Injury or compression of the nerve in the neck
  • Any sport, job, or home activity that requires repetitive gripping or upper limb motion such as throwing, hammering, etc.
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Diagnosing Carpal Tunnel Syndrome

A comprehensive history and physical examination is the most important piece to determine if the median nerve is involved in your wrist pain. Electrodiagnostic studies (EMG/NCS) look at the health and quality of your nerves. It can determine how severely the nerve may be damaged and at what location your nerve symptoms originate. Ultrasound is used to visualize the nerve and determine if there is any injury or swelling within the nerve.

Treatment Options

  • Optimizing your ergonomics to reduce stress on the nerve
  • Bracing may be needed to help of-load the nerve and prevent the wrist from bending to reduce nerve compression and facilitate healing
  • Physical therapy – To help reduce stress on the nerve. Nerve glides are exercises your therapist can teach you to try and reduce nerve irritation.
  • Medications– Usually NSAIDs or neuropathic pain medicines are used to help with pain and nerve irritability.
  • Steroid injections- Strong anti-inflammatory medications to reduce pain and inflammation. Typically done with ultrasound to guide the injection around the nerve.
  • Surgery- In rare circumstances, your doctor may refer you to a specialist to decompress the nerve if symptoms are very severe or unresponsive to conservative treatment.
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