Carpal Tunnel Syndrome

Definition/Occurrence

Carpal Tunnel Syndrome occurs when the median nerve which runs through the wrist to the hand becomes compressed. The problem involves the narrow bony passage in the wrist called the carpal tunnel, through which nine tendons and the median nerve must pass between the arm and hand.

In the wrist, the median nerve (the major "communication line" between the brain and the hand) is routed through a small passage bounded by the wrist bones (the carpals) and the tough ligament tissue connecting them (see diagram). Nine hard tendons also pass through this crowded "carpal tunnel". Because this structure is rigid, any influence that causes tissue swelling within the tunnel or reduces its size tends to compress and pinch the median nerve.

SYMPTOMS

  • Numbness and tingling sensation in one or both hands.
  • Frequently accompanied by sharp pains radiating through the arm or shoulder.
  • Muscle weakness of index and middle fingers and thumb.
  • Discomfort / aching in one or both hands.
  • Lack of feeling in hand may cause person to drop objects.
  • Activities requiring fine hand motor skills may prove difficult if not impossible.

    • TREATMENT

    When symptoms of carpal tunnel syndrome are minor or occur only during sleep, relatively simple measures to minimize swelling or otherwise limit median nerve compression may provide effective relief. Such efforts might include:

  • A splint to keep the wrist in a non-aggravating position during sleep or any activities which cause symptoms.
  • Cortisone injections to relieve wrist swelling.
  • Diuretics (water pills) to reduce fluid accumulation.
  • Vitamin B tablets.
  • Anti-inflammatory medications.

    • In a large percentage of cases, one or more of these non-operative measures are effective in controlling the symptoms of carpal tunnel syndrome.

    CARPAL TUNNEL RELEASE

    When these initial efforts fail to control symptoms, however, an operation called a carpal tunnel release is indicated. In this relatively simple outpatient procedure, the surgeon carefully cuts the wrist ligament, releasing the pressure inside the carpal tunnel, usually providing almost instantaneous relief from arm and hand pain and tingling.

    As the wound heals, new tissue will bridge the severed ligament in about six weeks, making the ligament long enough to create additional space inside the tunnel and prevent recurrence of symptoms in most cases.

    The hand surgeon is specifically trained and experienced in diagnosing, treating and, when possible, preventing disorders of the hand and upper extremity. A hand surgeon will generally have available all effective methods of carpal tunnel evaluation and treatment.

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    (904) 733-5550