Carpal Tunnel Syndrome


Are your hands asleep?  Do your hands go numb?



What is Carpal Tunnel Syndrome?:



Carpal Tunnel Syndrome is a Compression Neuropathy.  Specifically, it is compression of the Median nerve across the wrist.  In other words, it is a pinched nerve at the wrist.





What causes it?

The cause usually is unknown, but it can occur for several reasons.

Anything that puts pressure on the nerve can cause carpal tunnel syndrome, for example: tenosynovitis, joint dislocations and fractures, arthritis and keeping the wrist bent for long periods of time.

Carpal tunnel syndrome can also be seen during pregnancy because of swelling, but it typically will go away after delivery.

Certain medical conditions are also associated with carpal tunnel syndrome: thyroid conditions, rheumatoid arthritis and diabetes





Signs and Symptoms:

Carpal Tunnel syndrome symptoms typically include numbness, tingling, and pain.  The symptoms are usually felt during the night, but also can occur during daily activities such as driving or eating. Patients may notice clumsiness, a tendency to drop objects, and decreased grip. In severe cases, sensation may be permanently lost and the muscles at the base of the thumb may atrophy.











Diagnosis:

A detailed history and physical exam is performed.  An xray

may be taken to look for other causes of the complaints

such as fracture or arthritis.  A nerve conduction study (NCS)

and/ or electromyogram (EMG) can give further confirm the diagnosis and evaluate for other nerve problems.










Treatment:

Symptoms may be relieved with out surgery. Splinting the wrist and steroid injections may help relieve the symptoms by reducing swelling around the nerve.

If symptoms do not improve with conservative treatment than surgery may be necessary.  The goal of surgery is to: decrease the pressure on the nerve and enlarge the tunnel.

Recovery after surgery varies according to the method of surgery and the severity of the carpal tunnel syndrome.















Dr. Sonya M Clark