Carpal tunnel syndrome is a progressive condition caused by pressure on the median nerve in the wrist. The median nerve is responsible for feeling and movement in the thumb and first three fingers of the hand (excluding the little finger). This nerve extends down the forearm, through a narrow passage of bone and connective tissue, known as the carpal tunnel, and into the hand.
When swelling in the carpal tunnel occurs, pressure is placed on the median nerve causing pain, weakness, numbness and tingling that is felt in the thumb, fingers, hand and forearm. This condition is known as carpal tunnel syndrome. While the exact cause of carpal tunnel syndrome is difficult to identify, physical injury and repetitive stress are often responsible. A variety of medical conditions have been associated with carpal tunnel syndrome as well, including rheumatoid arthritis, diabetes and hypothyroidism.
Carpal tunnel syndrome should be treated as soon as possible, as symptoms can worsen over time. In mild cases, non-surgical treatment is often effective in providing relief. A corticosteroid injection helps reduce swelling in the affected tissues, which releases pressure from the median nerve. An immobilizing splint may be worn for several weeks or months to keep the affected wrist from bending. Ice and nonsteroidal anti-inflammatory drugs (NSAIDs) are other conservative treatments that can reduce swelling and provide pain relief.
If non-surgical treatments fail to relieve symptoms, carpal tunnel release surgery is often the next step. Carpal tunnel release surgery is one of the most common surgical procedures performed in the United States, and the outcome is usually quite successful. Medical trials have shown that 70 to 90 percent of patients that underwent carpal tunnel release surgery were completely free of nighttime pain afterward.
Carpal tunnel release surgery is an outpatient procedure that involves cutting the transverse carpal ligament to relieve pressure from the median nerve. The release procedure can be performed either through an open incision or through endoscopy.
Although carpal tunnel release surgery is typically very successful, it is not necessarily the right approach for everyone. There are several factors to consider with your doctor when deciding on the best method of treatment for your carpal tunnel syndrome. Factors that increase your chances of a successful surgical include:
- Being in good health
- Having surgery within three years of diagnosis
- Having good muscle strength before surgery
- Having symptoms that are worse at night than during the day
Some factors that may prevent a successful surgical outcome include:
- Continual numbness
- Muscle weakness
- Symptoms that have been present for more than 10 months
- Being over 50 years old
- Performing heavy manual labor, particularly working with vibrating tools (Source: University of Maryland Medical Center)
If you suffer from pain, tingling or numbness associated with carpal tunnel syndrome, don’t delay in scheduling an appointment with your doctor. Carpal tunnel syndrome is a progressive condition that can worsen over time, so the sooner you treat, the better your outcome will be!