From the performance of manual labor to the expression of love, our hands are essential in innumerable ways. But most of us don’t realize just how much our hands do for us until we must struggle to use them.
“We use our hands every day for everything from opening doors or picking up an infant to signing our name or typing a document on a keyboard,” says Dr. Kristopher Downing, an orthopedic hand and upper extremity surgeon affiliated with Sharp Chula Vista Medical Center.
Carpal tunnel syndrome, or CTS, occurs when the median nerve, which runs from the neck all the way to the hand and fingers, is squeezed as it passes through the passageway — the carpal tunnel of the wrist — that connects the forearm to the hand.
“Approximately one in four people will develop this painful condition, with women between the ages of 30 and 50 having the greatest risk due to pregnancy, birth control pills and menopause,” says Dr. Downing.
These factors are known to cause fluid shifts in the body that lead to increased swelling in the inelastic carpal tunnel that then leads to increased pressure on the median nerve, thereby leading to symptoms such as numbness and tingling, pain and weakness of the wrist and hand.
Treating carpal tunnel pain
Treatment can vary depending on the severity and duration of the condition, as well as the patient’s age, overall health, medical history and personal preference. Treatment is typically conservative and might include:
- Ergonomic adjustments
- Rehabilitation exercises for the wrist and hand
- Use of a splint
- Anti-inflammatory medications
- Steroid injections
- Surgery, if symptoms persist or repeatedly fail to improve with conservative treatment
In general, surgery for CTS, called carpal tunnel release, is a relatively straightforward outpatient procedure that involves an incision in the wrist area that varies in size based on whether the procedure is done in a minimally invasive way (i.e., endoscopic carpal tunnel release) or via a wide-open incision. Once the incision has been made, the ligament that is pressing on the nerves is cut to decrease pressure.
This procedure, one of the most commonly performed surgeries in the United States, is often completed in as little as 10-20 minutes, with many patients able to return to work and normal activities within one week. “While permanent damage to the nerves in the wrist and muscles of the hand and thumb are possible consequences of CTS, prompt attention reduces these risks,” explains Dr. Downing.
“What I tell my patients is — in order to avoid further complications related to untreated carpal tunnel syndrome — early intervention leads to an increased chance of complete or near complete resolution of symptoms.”