Carpal Tunnel Syndrome (CTS) is a cause of pain and functional problems in the hand and wrist. It results from the compression and pressure of the median nerve at the wrist and occurs anytime the carpal tunnel space at the wrist is compromised. This often recurs as a result of activities that repeatedly involve flexing of the hand at the wrist, resulting in swelling of the transverse carpal ligament.
Many people associate Carpal Tunnel Syndrome with data-entry jobs, but studies have found evidence that regular and prolonged use of hand-held vibratory tools increases the risk of Carpal Tunnel, especially among manufacturing and construction workers. Carpal Tunnel is three times more common among assembly workers in manufacturing, cleaning, and sewing.
Symptoms typically include numbness and tingling along the median nerve to the thumb, index finger, middle finger, and half of the ring finger. When severe, the nerve branches to the thumb muscles can be affected, resulting in weakening of thumb function. These symptoms can typically be eliminated with appropriate treatment. However, long-standing symptoms are often less responsive to complete reversal, even with treatment, resulting in permanent discomfort and loss of function. Carpal Tunnel Syndrome has the potential to significantly limit performance of many daily activities in patients if left unaddressed.
Identifying Carpal Tunnel Syndrome
An initial examination of the affected area is first completed. Findings typically reflect irritation of the median nerve in the hand and wrist area. Forced flexing of the hand at the wrist will typically aggravate a patient’s symptoms. To verify the diagnosis of carpal tunnel syndrome, the patient is typically sent for Electromyography (EMG), which tests the nerve impulses across the carpal tunnel area. Carpal Tunnel Syndrome is confirmed with demonstration of significant slowing of the nerve impulse transmission through the carpal tunnel area.
In many patients, symptoms are self-limiting or may resolve with conservative measures including splinting the wrist (especially at night), anti-inflammatory medication, and activity modification. Injection of steroids into the area may result in relief of symptoms, but is very often only temporary.
If conservative treatment is not effective, surgical options have been shown to relieve symptoms in a high percentage of patients. For those suffering from Carpal Tunnel Syndrome, there is no need to have
pain, functional limitation, or sleep loss when surgery produces such a favorable and effective result.
Surgery for Carpal Tunnel Syndrome is performed as an outpatient procedure, typically under local or regional anesthesia. Surgery involves the complete division of the transverse carpal ligament. This release frees up pressure on the median nerve, relieving the patient’s symptoms.
Compressive dressings are usually applied, with close follow-up in the clinic for dressing changes and stitch removal at 10 days. The hand may be carefully used as tolerated, but a return to work and full activity will be individualized, largely based on the patient’s report of usual activities.
The symptoms of Carpal Tunnel Syndrome may make even simple tasks hard to perform. Dr. Emile Li of Orthopedic Specialists states “Patients don’t need to suffer from their pain. There are many treatments available and we always recommend coming in for a physical examination. Carpal Tunnel Syndrome can often be successfully treated with a return to normal function.” If you have recurring pain or the above symptoms, schedule an appointment with Orthopedic Specialists today.