Your hands are working in essentially all the moments of your day, from waving to neighbors to shaking on a new business deal, typing up the next great American novel to tickling your kids or grandkids. These movements – from routine to monumental – become anything but easy if you have carpal tunnel syndrome. When you feel your tennis game slipping or even become hesitant to text someone back from carpal tunnel-related pain, look no further than contacting the hand and upper extremity specialists at The Orthopaedic Center. Our world-class physicians with state-of-the-art technology are ready to expertly diagnose and treat your condition, getting your hands and wrists back to playing, pointing, typing, and all the other things that make you, you.
Understanding the causes of carpal tunnel involves understanding a little of the anatomy of the wrist and hand. The carpal tunnel is a narrow space in the wrist. The median nerve runs through the carpal tunnel. Originating from the neck and continuing through the elbow and forearm, the median nerve is a major nerve in the hand that is responsible for sending signals to the base of the thumb, index finger, middle finger, and thumb-side of the ring finger. Rigidly strong tissue called the transverse carpal ligament provides a roof over the carpal tunnel. Anything that causes irritation or pressure on the median nerve can reduce blood supply in the carpal tunnel and/or cause nearby tendons or tissues to swell or thicken, resulting in pain – otherwise known as carpal tunnel syndrome.
While a complete list of causes of carpal tunnel syndrome is not clear, there are known risk factors for the condition. You may have a combination of risk factors that ultimately leads to a diagnosis. If you have certain anatomy or genetics, such as smaller-sized carpal tunnels or bone deformities in your wrists from arthritis, you may be at risk for developing carpal tunnel syndrome. Certain diseases (such as diabetes), inflammatory conditions (such as rheumatoid arthritis), and conditions that cause fluid retention (such as pregnancy and menopause) may also place you at increased risk. Carpal tunnel syndrome is more common in women, older adults, and people who are obese. Performing repetitive motions of the wrist/hand may be a contributing factor.
The classic symptoms of carpal tunnel syndrome are tingling and numbness in your fingers or hand, but not usually in the pinkie finger. Shock-like sensations may travel from your fingers up your arm at any time of the day and may even wake you from sleep. You may find you drop things more often than usual or have trouble buttoning clothes or making a fist. Your hands may cramp, especially in the morning. These symptoms start gradually in one or both hands and if left without proper treatment, may result in permanent nerve or muscle damage.
It’s important to be mindful of your wrist alignment throughout the day, as bent wrists can increase pressure in the carpal tunnel. Try hitting the keys more softly if you type at work, or soften your grip while driving to avoid white knuckles. You may be prescribed a wrist splint to wear during the day or while you sleep to keep your wrist in neutral alignment, helping your carpal tunnel stay open.
Over-the-counter (OTC) or prescription pain medications may also be prescribed. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen may offer relief for some patients but may not be recommended for long-term management because of the risk of various side effects. Cortisone injections, a type of corticosteroid, may be given directly into the wrist to reduce tissue swelling. Cortisone injections may resolve symptoms temporarily.
If you and your care team decide surgery is in your best interest, a carpal tunnel release can be performed, often times as an outpatient – meaning you get to sleep at home that night. With a carpal tunnel release, the transverse carpal ligament is cut, increasing the size of the carpal tunnel to relieve pressure on the median nerve. The transverse carpal ligament may grow back post-op, but the median nerve won’t experience pressure as it did before. Recurrence occurs in around 10% of those who undergo carpal tunnel release.
A carpal tunnel release can be done using either an open or endoscopic approach. In an open approach, an incision is made in the palm of your hand for the surgeon to establish a visual field. With an endoscopic approach, one or two smaller incisions are made into your palm for a small camera called an endoscope to provide the surgeon’s view of the operating area.
Wave Goodbye to Carpal Tunnel Syndrome at The Orthopaedic Center
As North Alabama’s first and largest team of hand specialists, The Orthopaedic Center is the premier destination for high quality care of a host of upper extremity conditions, including carpal tunnel syndrome. If hand pain is stopping you from living the life you love, now is the time to get the proper diagnosis and care you deserve. To request an appointment with our board-certified and compassionate hand and upper extremity specialists, please click here.