Carpal Tunnel Syndrome
The median nerve is a major nerve that runs from your upper arm through an inch-wide passageway in your wrist, known as the carpal tunnel. The median nerve provides sensation to all fingers except the pinkies. It also controls the muscles around the base of the thumb.
When the median nerve is squeezed or compressed, numbness, tingling or pain may occur, a condition known as carpal tunnel syndrome.
Causes
Carpal tunnel syndrome is more common in women than in men, and there can be many causes, including:
- Repetitive hand motions
- High-force activities, such as hammering
- Long-term use
- Extreme wrist motions
- Vibration
- Inflammatory diseases, such as rheumatoid arthritis
- Obesity
- Heredity
- Hand and wrist position
- Pregnancy
- Diabetes
- Thyroid gland imbalance
- Gout
- Alcoholism
- Tumor
- Aging
Symptoms
In many cases, carpal tunnel syndrome symptoms worsen gradually and don’t seem connected to a specific injury. You may find the symptoms come and go, then become more regular as the condition progresses.
Carpal tunnel syndrome may wake you up at night, especially if you sleep with your wrist curled. Night pain is often the first symptom people notice.
Symptoms of carpal tunnel syndrome include:
- Numbness, tingling, burning and pain that may travel up your arm.
- Radiating, shock-like sensations in your hand.
- Weakness and dropping things.
- Clumsiness when using the hands for things like buttoning a shirt.
- Difficulty with tasks that involve bending the wrist, such as grasping a steering wheel, reading a newspaper, writing, using a phone or working on a computer.
Shaking your hands may help relieve early symptoms but can become less effective over time.
Diagnosis
Your doctor will ask about your health, review your medical history and evaluate your symptoms by:
- Checking for Tinel’s sign, a tingling sensation when the median nerve is tapped or depressed at your wrist.
- Bending and flexing your wrist to test for numbness or tingling in your hands.
- Lightly touching your fingertips with a special instrument while your eyes are closed to test for sensitivity.
- Examining your thumb to look for signs of weakness or atrophy of the muscles.
Further tests may be indicated, including:
- X-rays if there is limited wrist motion or evidence of arthritis or trauma.
- Electromyography (EMG) or nerve conduction to test muscle movement.
- Lab tests to reveal inflammation.
- Ultrasound to see if there is compression of the median nerve.
- Magnetic resonance imaging (MRI) to scan for abnormal tissue, tumors or scarring.
Treatment
It’s important to contact your doctor right away if you have symptoms of carpal tunnel syndrome. When discovered early, non-surgical treatment may relieve your symptoms.
Non-surgical options include:
- Wearing a splint.
- Taking anti-inflammatories, such as Tylenol® or ibuprofen.
- Steroid injections.
- Hand exercises.
- Environmental changes in your workplace.
- The height or position of your desk chair.
- The position of your mouse and keyboard.
- Your posture while sitting.
- The position of your hand and wrist while working.
If these non-surgical treatments don’t work, your doctor may recommend carpal tunnel release, an outpatient procedure to relieve pressure on your median nerve. Your wrist will be bandaged and may require a splint for a week or two after surgery, after which your doctor may prescribe physical therapy. Recovery can take from a few days to a few months.
If you are experiencing pain, numbness or tingling in your hands, call our office immediately at (978) 794-1946 or (603) 898-2244 for an evaluation, or take advantage of our walk-in clinic in Haverhill and Andover Monday–Friday, 8am–12pm and 1–3pm.
