A common question I hear from patients is, “Do I have carpal tunnel?” This is one of the most well-known hand conditions and can certainly cause problems and impact daily activities for those who have it. But what actually causes it, what are the symptoms, and how can it be treated?
What can cause carpal tunnel syndrome?
Pressure or pinching of the median nerve as it passes through the wrist is what causes carpal tunnel syndrome. This may be the result of multiple issues, including:
- repetitive motion activities (keyboarding, knitting, vibrating tools)
- fluid retention, such as with pregnancy
- injury to the wrist (fractures/dislocations)
- thyroid disease
- inflammatory diseases (chronic inflammation in conditions such as rheumatoid arthritis can contribute)
What are the symptoms of carpal tunnel syndrome?
Most patients with carpal tunnel syndrome experience one or more of the following symptoms:
- numbness in the hands that wakes them up at night (mostly thumb, index and middle fingers)
- pain and/or pins and needles sensations (called paresthesias)
- dropping objects from their hands
- weakness, mostly in the thumb
- decreased dexterity with everyday use of the hands
How is carpal tunnel syndrome treated?
Treatment varies from patient to patient and is based on relieving the symptoms. I usually recommend starting with nighttime splinting of the affected wrist. Most people sleep with their wrists and elbows flexed. Nighttime splinting can help to improve early symptoms by repositioning the wrist in slight extension. For more involved cases that do not improve with splinting, conservative treatment can include corticosteroid injections.
If symptoms persist despite the conservative measure of nighttime splinting or anti-inflammatory medications, then referral to a hand provider may be recommended for further evaluation. Some patients are then referred for testing with a nerve conduction study which evaluates the median nerve in the hand and assesses the degree of compromise. If indicated, surgical release of the carpal tunnel relieves the pressure by cutting the ligament that puts pressure on the median nerve at the wrist.
If you have any of the above symptoms and think you may have carpal tunnel syndrome, talk to your Certified PA.