CTS typically manifests gradually with burning, tingling or itching numbness in the palm and fingers.
Understanding Carpal Tunnel Syndrome
The anatomy of the wrist’s carpal tunnel, a narrow passageway on the palm side of your wrist, plays a pivotal role. This tunnel houses tendons and the median nerve. Swelling can narrow the tunnel and cause nerve compression, leading to CTS.
Symptoms and Identification
CTS typically manifests gradually with burning, tingling or itching numbness in the palm and fingers. Waking at night to “shake out” one’s hands is also common. As symptoms worsen, people might experience decreased grip strength and a tendency to drop objects. The condition is commonly diagnosed using a combination of patient history, physical examinations and tests such as nerve conduction studies, which measure the nerve’s ability to send impulses, or ultrasound, which measures the size of the nerve.
Nonoperative Treatments
Initial treatment strategies focus on relieving symptoms without surgery. These include:
- Wrist Splinting: Wearing a splint at night to keep the wrist straight helps relieve nighttime symptoms of numbness and tingling.
- Medications: Oral nonsteroidal anti-inflammatory drugs (NSAIDs) and/or corticosteroid injections can help relieve pain and inflammation.
- Activity Changes: Modifying hand and wrist activities can alleviate symptoms.
- Nerve Gliding Exercises: Exercises that help the median nerve move more freely within the confines of the carpal tunnel can be beneficial.
These nonoperative therapies are often effective in managing mild to moderate symptoms of CTS.
When Surgery is Necessary
For patients whose symptoms fail to respond to conservative measures or in cases of severe CTS, surgery might be more beneficial. The surgical procedure, called carpal tunnel release, involves cutting the band of tissue around the wrist to reduce pressure on the median nerve. This surgery can be performed under traditional anesthesia or using an innovative approach known as WALANT (Wide Awake Local Anesthesia No Tourniquet), which allows the patient to remain awake without the need for preoperative fasting or postoperative grogginess. Both open and endoscopic methods are available, depending on the patient’s condition and the surgeon’s assessment.
Recovery and Rehabilitation
Post-surgery, the recovery process involves a gradual return to activity and, occasionally, physical therapy to restore wrist and hand strength and flexibility. Most patients fully recover and resume their normal activities within weeks to months following the procedure.
Risk Factors and Preventive Measures
Individuals who frequently use their hands in their professional activities may be at an increased risk of developing CTS. Preventive measures include maintaining proper ergonomic setups at workstations, taking regular breaks to stretch and flex the hands and wearing appropriate wrist supports when performing tasks that could strain the wrist. FBN
By Derek B. Smith, M.D.
Dr. Derek Smith is an upper extremity specialist focusing on the hand, wrist and elbow care. Dr. Smith offers both nonoperative and surgical treatments tailored to each patient’s individual needs. With a commitment to advanced, patient-centered care, Dr. Smith helps individuals regain their function and minimize discomfort through state-of-the-art therapies and techniques.
For more details about Dr. Smith and the comprehensive services available at Flagstaff Bone and Joint, visit our website at www.flagstaffboneandjoint.com, call 928-773-2280, or text 928-628-6391.
Leave a Reply