Screen_Shot_2024-04-12_at_9.jpegCarpal tunnel syndrome is a nerve function disorder that can cause pain and numbness in the wrists and hands. It affects as much as 5% of the general population and is especially prevalent in office workers, musicians, and other professionals who frequently use their hands for extended periods of time.

At Jefferson Orthopedic Specialists, we've seen countless cases of carpal tunnel syndrome and have effectively treated patients with both surgical and non-surgical methods.

Using our expertise, we've put together this comprehensive guide to carpal tunnel syndrome.  Read on to learn about this common condition's symptoms, causes, and treatment options.

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Understanding Carpal Tunnel Syndrome

The carpal tunnel is a narrow passageway located on the palm side of your wrist. This crucial area houses the median nerve and nine tendons that bend your fingers. It is bordered by the carpal bones on the underside and sealed off by the transverse carpal ligament on the top.

The carpal tunnel's anatomy is designed to protect and facilitate the movement of these tendons and the median nerve, which provides sensation to the thumb, index, middle, and ring fingers. Its structure is vital for the flexibility and function of the hand and wrist, enabling a wide range of hand and finger movements.

Carpal Tunnel Syndrome Symptoms

A good way to familiarize yourself with carpal tunnel syndrome is by understanding its symptoms. The most common symptoms include:

  • Pain and numbness in the wrist, hand, and fingers (especially the thumb, index, middle, and ring finger)
  • Intermittent hand pain or wrist pain
  • Need to 'shake out' hands to relieve symptoms

These are the baseline symptoms that most with the condition will experience, even in mild cases. However, there are also some more severe symptoms that those with a progressed version of this condition might experience. These include:

  • Increased numbness
  • Muscle damage
  • Limited wrist motion

Who's At Risk For Developing Carpal Tunnel Syndrome?

Carpal tunnel syndrome develops when there's increased pressure on the median nerve within the carpal tunnel space, often due to swelling or any condition that reduces the space within the tunnel. Several risk factors contribute to the development of carpal tunnel syndrome, including the following:

  • People who participate in repetitive hand movements (common with frequent computer keyboard use)
  • Those who hold their wrist in an incorrect position
  • People with an abnormal anatomical structure of the wrist, such as smaller carpal tunnels
  • Those with wrist injuries
  • People with conditions like rheumatoid arthritis or various neurological disorders

These elements can either directly compress the median nerve or increase the pressure within the carpal tunnel, leading to the symptoms associated with carpal tunnel syndrome.

Diagnosing Carpal Tunnel Syndrome

If you believe that you've developed carpal tunnel syndrome, your next step is going to be a professional diagnosis. Here, we'll provide a glance into what that process actually looks like.

Medical History and Physical Exam

A comprehensive medical history and an exam are foundational for your doctor to diagnose carpal tunnel syndrome. These steps allow healthcare professionals to gather crucial information about symptoms, risk factors, and any activities that may contribute to the condition.

Medical History: Includes discussing symptoms such as hand numbness, pain, and any nocturnal discomfort. A detailed account of the patient's history helps identify potential causes or contributing factors, such as repetitive hand movements or wrist injuries.

Physical Exam: Focuses on identifying physical signs of carpal tunnel syndrome. The exam may involve:

  • Checking for swelling, tenderness, and changes in the hand's appearance.
  • Assessing sensation in the fingers and strength of the hand muscles.
  • Performing specific tests like the wrist flexion test (Phalen’s test) and Tinel’s sign to evaluate median nerve entrapment.

Advanced Diagnostic Tools

Beyond the initial examination, further diagnostic tools are crucial for confirming a carpal tunnel syndrome diagnosis and differentiating it from other conditions.

  • Nerve Conduction Studies: This test measures the speed and strength of electrical signals passing through the median nerve. Slowed conduction can indicate compression of the nerve within the carpal tunnel. Nerve conduction studies are pivotal in diagnosing carpal tunnel syndrome and assessing the extent of damage to the nerve.
  • Imaging: Techniques such as ultrasound and MRI can visualize the structure of the carpal tunnel, showing changes in the median nerve or surrounding tissues. Imaging helps confirm the diagnosis and can also reveal other potential causes of symptoms, such as cysts or arthritis

Treating Carpal Tunnel Syndrome

Treating carpal tunnel syndrome (CTS) involves a combination of non-surgical and surgical methods aimed at relieving pressure on the median nerve and alleviating symptoms. The choice of treatment depends on the severity of the condition, the presence of nerve damage, and how well non-surgical treatments are working.

Non-Surgical Treatments

Non-surgical treatments are often the first line of defense against the symptoms of carpal tunnel syndrome and aim to reduce the compression of the median nerve.

  • Wrist Splints: Holding the wrist in a straight or neutral position, especially at night, can help relieve the pressure on the nerve in the carpal tunnel area, reducing nighttime symptoms and promoting healing.
  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Medications such as ibuprofen can reduce swelling and alleviate pain, although they do not relieve the compression on the median nerve directly.
  • Nerve-Gliding Exercises: These exercises help the median nerve move more freely within the confines of the carpal tunnel and can reduce symptoms if practiced regularly.
  • Lifestyle Modifications: Making ergonomic adjustments to work and daily activities can help prevent further strain on the wrist. Frequent rest breaks, maintaining a straight wrist position, and avoiding activities that increase pressure on the median nerve are recommended.

Surgical Treatments

Surgery is considered when non-surgical treatments fail to relieve symptoms or in severe cases where there is significant damage to the nerves.

Indications for Surgery

  • Persistent, severe symptoms that interfere with daily activities.
  • Evidence of nerve damage on a nerve conduction study.
  • Lack of response to nonsurgical treatments over a period of several months.

Types of Surgery

Carpal Tunnel Release Surgery is the most common surgical procedure for treating CTS. It involves cutting the transverse carpal ligament to relieve pressure on the median nerve. This surgery can be performed using traditional open surgery or endoscopic techniques, which use smaller incisions and may allow for quicker recovery times.

Post-surgical Care and Recovery

  • Recovery varies but often involves wrist splinting, pain medication, and physical therapy to restore wrist and hand function.
  • Most patients experience a significant reduction in symptoms, although recovery can take several weeks to several months.
  • Orthopedic surgeons or neurological surgeons often oversee the post-surgical care to ensure optimal recovery and function restoration.

Carpal Tunnel Syndrome Prevention and Management

Finally, we'll discuss how you can help prevent carpal tunnel syndrome from developing and how you can better manage your symptoms in cases where a diagnosis is inevitable.

Preventing Carpal Tunnel Syndrome

Preventing carpal tunnel syndrome (CTS) centers around minimizing stress on the hands and wrists through various strategies. Adopting these practices can significantly reduce the risk of developing CTS.

  • Ergonomic Practices: Using ergonomic keyboards, mice, and workstations can help keep the wrists in a neutral position, reducing strain.
  • Wrist Position: Keeping the wrist straight and aligned with the forearm, rather than bent or extended, can prevent compression of the median nerve.
  • Frequent Breaks: Regularly scheduled breaks during work or activities that strain the wrist can alleviate pressure and prevent CTS. This is especially important for tasks that involve repetitive hand or wrist movements.
  • Early Intervention: Recognizing early symptoms of carpal tunnel syndrome and taking immediate steps to adjust activities and seek treatment can prevent the condition from worsening.

Managing Symptoms

Once diagnosed with carpal tunnel syndrome, managing symptoms and facilitating recovery become paramount. The approach often combines medical treatment with lifestyle modifications.

  • Wrist Splints at Night: Using a wrist splint while sleeping can keep the wrist in a neutral position, relieving nighttime symptoms and pressure on the median nerve.
  • Pain Medication:  Anti-inflammatory medications can help reduce pain and swelling, contributing to a more comfortable recovery.
  • Lifestyle Adjustments:  Modifying daily activities to avoid excessive wrist flexion or extension and implementing frequent breaks can significantly reduce symptoms.
  • Physical Therapy: Physical therapy plays a crucial role in restoring wrist and hand function after carpal tunnel release surgery or as part of nonsurgical treatment. Techniques may include exercises to strengthen the hand and wrist, improve flexibility, and ensure proper wrist bone and connective tissue healing.

Get Treatment Today With Jefferson Orthopedic Specialists

We strongly encourage anyone experiencing symptoms consistent with carpal tunnel syndrome to seek professional medical advice as soon as possible. Timely consultation can significantly improve the outcome and reduce the likelihood of long-term complications associated with the condition! Luckily, Jefferson Orthopedic Specialists is here to help.

We don't just treat carpal tunnel syndrome; we're your partners in restoring your overall physical well-being. The impacts that having an ailment like carpal tunnel syndrome can have on you are immense, but our specialist team is here to get you back to doing the things that you love—pain-free.

Don't let Carpal Tunnel Syndrome hold you back. Contact our highly skilled team of orthopedic and physical therapy specialists at  Jefferson Orthopedic Specialists to request a consultation today. Start your journey towards a healthier, more active future with a partner committed to your recovery and well-being.

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