What Do I Need to Know About Carpal Tunnel Syndrome?

Chances are you’ve heard of carpal tunnel syndrome, a common disorder that affects almost 2 million people in the United States. But do you know who’s more likely to develop it or how it’s treated? Read on to learn more.

Carpal tunnel anatomy

One of the major nerves to the hand, the median nerve, runs from your forearm through a narrow passage in your wrist, called the carpal tunnel, then down into the palm of your hand. The nerve provides feeling to all of your fingers, except your little finger, and controls some muscles at the base of your thumb.

When the nerve becomes pressed or squeezed at the wrist, you may start to experience numbness, weakness or pain in the hand, wrist, forearm and arm. You might even drop things due to a decrease in grip strength.

Risk factors

Carpal tunnel syndrome is caused by a variety of factors. While some factors make the development of carpal tunnel syndrome more likely, the majority of patients do not have a specific reason for developing it.

People with diabetes, rheumatoid arthritis and thyroid disease have an elevated chance of developing carpal tunnel syndrome. In particular, research indicates that people with diabetes can be up to four times more likely to develop carpal tunnel syndrome.

“Carpal tunnel syndrome can affect anyone,” says Luke Thomas Nicholson, MD, an orthopaedic hand surgeon for USC Orthopaedic Surgery, part of Keck Medicine of USC. “Most of my patients with carpal tunnel syndrome do not have a specific risk factor for it, other than being human. This is important to understand because patients’ natural tendency is to blame their activities for it and to stop doing those activities. But we don’t want you to stop doing the things you love.”

How it’s treated

Once you’ve been diagnosed with carpal tunnel syndrome, your doctor may suggest a nonsurgical or surgical treatment plan.

Nonsurgical treatments can include:

• Wearing a brace or splint at night to prevent your wrist from bending while you sleep
• Over-the-counter medications to alleviate pain
• Steroid injections for temporary relief of symptoms
• Avoiding activities that exacerbate symptoms
• Yoga to reduce pain and increase grip strength

The type of treatment required depends on how significant the nerve compression is. For some patients, wearing a splint at night might be the only treatment they need.

Others may require surgery right away. Carpal tunnel surgery is a short procedure that involves opening the carpal ligament that is causing pressure on the median nerve.

“Performing a carpal tunnel release can be one of the most gratifying procedures in orthopaedics,” says Dr. Nicholson. “Patients often have immediate relief of their symptoms and wish they had done it sooner. I particularly enjoy treating patients for carpal tunnel release in the office setting, where patients can avoid the stress of being in an operating room and the strings that go along with it.”

For some people, their hands will feel completely normal after surgery. Other people may have some symptom improvement, while some will have no improvement at all.

“It is extremely important to understand how the severity of carpal tunnel syndrome affects outcomes after carpal tunnel release,” Dr. Nicholson says. “Patients with severe carpal tunnel syndrome may already have permanent nerve damage that is not going to improve with surgery; for these patients, a carpal tunnel release may still be beneficial to prevent the progression of the nerve damage, but it is important to understand this expectation before the procedure. Likewise, in patients with moderate carpal tunnel syndrome, we may recommend carpal tunnel release to prevent the progression to permanent nerve damage.”

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