What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome, CTS, is a painful condition caused by the overuse of the hands and wrists. Essentially, a nerve in the wrist becomes compressed, also known as a “pinched nerve” and causes pain. Compression occurs when the tunnel of wrist bones experiences some type of inflammation. This causes the tunnel to narrow and press on the median nerve and tendons that travel from the forearm to the hand. Patients whose occupation involves repetitive wrist actions or strenuous hand and wrist movements are at risk for developing carpal tunnel syndrome. In addition, pregnant women and older individuals are more likely to suffer from CTS.
What Causes Carpal Tunnel Syndrome?
Some studies suggest that health conditions such as diabetes, arthritis, and thyroid conditions could contribute to swelling in the carpal tunnel. In addition, compression of the median nerve can be caused by:
- Joint dislocation
- Swelling in the lining of flexor tendons in the wrist (tenosynovitis)
- Fluid accumulation and inflammation during pregnancy
Symptoms Of Carpal Tunnel Syndrome
Carpal tunnel syndrome has distinctive symptoms, but some of them may be attributed to other nerve disorders or degenerative conditions. CTS symptoms often develop gradually and worsen over time. It is common for symptoms to be most severe when a person first wakes up. Any symptom that suggests carpal tunnel syndrome should be thoroughly evaluated by our physicians so an accurate diagnosis can be made and the most appropriate treatment plan can be developed.
It is important to note that symptoms such as weakness, tingling, and numbness may worsen when the hand is held in one position, such as when holding a book or driving. These symptoms may also occur or worsen when performing repetitive motions such as typing or knitting. Symptoms can include:
- Tingling, numbness, or a burning sensation in the hand and fingers. These symptoms tend to occur near the thumb, index, and middle fingers.
- A sensation of wanting to “shake out” the hand due to tightness, tingling, or numbness. This may be worse in the morning or at night.
- An aching sensation in the wrist and/or hand.
- Pain that radiates from the wrist up to the forearm toward the elbow, but typically not beyond.
- Difficulty gripping or holding objects due to weakness in the hand or fingers.
- Sensation changes in the hand, such as feeling hot or cold.
- In severe cases, muscle atrophy at the base of the thumb.
Carpal Tunnel Treatment
Treatment for carpal tunnel syndrome may start conservatively such as wearing supportive wrist braces at night. This will help keep your wrists in a neutral position avoiding wrist flexion and further compression of the nerve. In addition, cortisone injections are likely to help relieve symptoms.
If symptoms persist, surgery is an excellent option and is the most reliable way to provide long-lasting relief. There are different techniques available, but the least invasive technique available is endoscopic carpal tunnel release. This minimizes recovery time to typically just a week or 2.
“I had suffered with carpal tunnel syndrome in both hands for 5 years, this past year being the worst, and all other treatments hadn’t worked. When I first met Dr. Peter DeNoble, we discussed the option of surgery. Well, as far as surgery goes it was an awesome experience. Dr. DeNoble and his assistant had such a peaceful way about them. I was very comfortable through the procedure and it was over in 20 minutes…” -Claire K.
Am I a Candidate for Carpal Tunnel Treatment?
If your symptoms have been diagnosed as carpal tunnel syndrome and are interfering with your daily activities, you may be an excellent candidate for treatment. Typically, non-surgical therapies are prescribed first. The objective of conservative care is to reduce the stress on the wrist and thus reduce inflammation that is pressing on the median nerve. If you have tried therapies such as splinting and injections of corticosteroid without the degree of success you’d like, surgery may be an option to consider. Patients are likely to consider surgery in order to avoid long-term damage, such as nerve damage, which can affect function in the hand and fingers.
Endoscopic Carpal Tunnel Release
At Advanced Orthopedics & Hand Surgery Institute, we perform endoscopic carpal tunnel release. The objective of surgery is to relieve compression on the median nerve. The procedure is relatively low-risk but is generally not recommended until conservative methods of care have been utilized for six months or more. An exception would be the sudden onset of acute carpal tunnel symptoms or presence of severe nerve impingement at the time of diagnosis.
During carpal tunnel surgery, also called carpal tunnel release, one of our many highly qualified physicians will insert a tiny camera, an endoscope, into the carpal tunnel. Once good visualization is achieved, they will sever the transverse carpal ligament, a structure that runs horizontally across the wrist. This allows the tunnel to open up and decompresses the median nerve. Cutting this ligament does will not cause loss of strength or function. Since this surgery is performed endoscopically, scars are minimized, there is less pain, and recovery is quicker.
Benefits of Carpal Tunnel Surgery
The primary benefit of undergoing surgery is to release compression on the median nerve. With that release, your symptoms will either be significantly reduced or eliminated altogether. In the broader scope, carpal tunnel surgery can restore hand and finger strength and flexibility. This enables patients to get back to the life they want to live.
What Are the Risks of Carpal Tunnel Release?
Risk and complication rates are extremely low with this procedure. Major problems such as nerve damage happen in less than one percent of surgeries. However, as with any surgical procedure, there are risks. These are rare but can include injury to nerves, blood vessels, and tendons.
Carpal Tunnel Surgery Recovery
Patients typically take a month to recover from carpal tunnel release. During the first five days after surgery, patients will wear a bandage on their hand and wrist. After five days, patients can remove the bandage and simply cover the incision with a Band-Aid. After two weeks, patients will return for a follow-up visit and have their stitches removed. At this point, patients can resume all of their daily activities. Generally, physical therapy is not a required part of recovery. For more recovery information view our post-op instructions.
Results of Carpal Tunnel Release
After surgery, most patients have few if any of their former symptoms in their hand and fingers. At the Advanced Orthopedics & Hand Surgery Institute, we have had phenomenal success with this procedure. There are rare cases when the pain and numbness return if the thumb muscles have been severely weakened or have wasted away by prolonged compression of the nerve. When symptoms are severe, some patients have trouble gaining back the strength in their hand and its function, despite relieving the compression on the nerve.
Schedule a Consultation
If you suffer from carpal tunnel syndrome and would like information on treatment call (973) 942-1315 to schedule a consultation with one of our orthopedic specialists. We have three convenient locations in Wayne, Clifton, and Parsippany and serve patients from all over New Jersey!