Understanding Carpal Tunnel Syndrome: Symptoms, Treatment, and Surgical Options
By Miss Jurga Pikturnaite
Carpal Tunnel Syndrome (CTS) is a common condition that affects millions of people worldwide. Characterised by pain, numbness, and tingling in the hand and arm, CTS occurs when the median nerve, which runs from your forearm into the palm of your hand, becomes compressed at the wrist. Whether you're dealing with mild symptoms or considering surgery, this guide will help you navigate your options for easing carpal tunnel pain.
What Are the Signs of Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome often starts gradually, with symptoms that may come and go. Early recognition of these signs is crucial for effective management. The common signs of CTS include:
Numbness or Tingling: This typically occurs in the thumb, index, middle, and ring fingers, but not in the little finger. The sensation may feel like "pins and needles" and often occurs while holding a steering wheel, phone, or newspaper.
Pain: Pain may extend from your wrist up your arm to your shoulder or down into your palm and fingers. This pain can also radiate to the shoulder and neck, especially in severe cases.
Weakness: Many people with CTS experience weakness in their hand, making it difficult to grasp objects or perform fine motor tasks like buttoning a shirt.
Reduced Grip Strength: Over time, the muscles at the base of the thumb may weaken, leading to a reduced ability to grip objects.
If you experience these symptoms, especially if they persist or worsen over time, it is essential to seek medical evaluation. Early diagnosis and treatment can prevent further damage to the median nerve.
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Miss Pikturnaite shares how to test for Carpal Tunnel Syndrome, tips on easing Carpal Tunnel pain, expands on Carpal Tunnel Release Surgery and more.
How to Test for Carpal Tunnel Syndrome
Several tests can help diagnose carpal tunnel syndrome:
Tinel's Sign: A doctor taps on the median nerve at the wrist to see if it causes tingling in the fingers.
Phalen's Maneuver: This test involves holding your forearms upright by pointing the fingers down and pressing the backs of the hands together. Tingling or numbness within a minute suggests CTS.
Nerve Conduction Studies: These measure the electrical impulses in the median nerve and can confirm the diagnosis and severity of carpal tunnel syndrome .
How to Ease Carpal Tunnel Pain
Easing carpal tunnel pain often begins with lifestyle changes and non-invasive treatments. Here are some strategies:
Wrist Splints: Wearing a wrist splint, especially at night, can keep your wrist in a neutral position and reduce pressure on the median nerve.
Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce inflammation and alleviate pain.
Physical Therapy: Specific exercises can help stretch and strengthen the muscles in the wrist and hand, potentially relieving symptoms.
Ergonomic Adjustments: Adjusting your workstation to ensure proper wrist alignment can prevent further strain.
Corticosteroid Injections: In some cases, corticosteroid injections can reduce inflammation and provide temporary relief from symptoms.
Can Carpal Tunnel Pain Radiate to the Shoulder and Neck?
Yes, carpal tunnel pain can radiate to the shoulder and neck. While the primary symptoms are felt in the hand and wrist, the discomfort can extend up the arm, particularly if the condition is severe. This occurs because the median nerve runs from the neck down to the hand, and compression or irritation of the nerve at the wrist can sometimes cause referred pain in other parts of the arm.
Why is Carpal Tunnel Worse at Night?
Carpal tunnel symptoms often worsen at night due to wrist positioning during sleep. Many people sleep with their wrists bent, which increases pressure on the median nerve. Additionally, fluid accumulation in the arms and hands while lying down can contribute to swelling around the carpal tunnel, exacerbating symptoms.
When is Carpal Tunnel Bad Enough for Surgery?
Surgery is usually considered when:
Symptoms are Severe: If pain, numbness, or weakness is significant and affects daily activities.
Non-Surgical Treatments Fail: When conservative treatments such as splints, medication, or injections no longer provide relief.
Nerve Damage is Evident: Nerve conduction studies indicate significant damage or the risk of permanent nerve injury.
What is Carpal Tunnel Release Surgery?
Carpal Tunnel Release Surgery is a procedure designed to alleviate the pressure on the median nerve by cutting the transverse carpal ligament that forms the roof of the carpal tunnel. This surgery can be performed in two ways:
Open Release Surgery: A small incision is made in the palm to access and cut the ligament.
Endoscopic Surgery: A smaller incision is made, and a tiny camera guides the surgeon as they cut the ligament. This option is rarely employed due to increased risk of nerve injury.
The goal of both procedures is to increase the size of the carpal tunnel and relieve pressure on the median nerve, ultimately reducing pain and restoring function .
How Long Does Carpal Tunnel Surgery Take?
Carpal tunnel release surgery is typically a quick procedure, lasting about 15 to 20 minutes. Most patients can go home the same day.
How Long After Carpal Tunnel Surgery Can I Drive?
Most patients can resume driving within 1-2 weeks after surgery, depending on their recovery and the return of grip strength and comfort in the hand. In some cases it can take up to 6 weeks to feel comfortable and confident gripping a steering wheel again. It's important to have full control of the steering wheel and be pain-free before driving again.
What Type of Surgeon Does Carpal Tunnel Surgery?
Carpal tunnel surgery is commonly performed by plastic surgeons and orthopaedic surgeons, who specialise in treating conditions of the hand and upper extremities. These specialists have the expertise to manage both non-surgical and surgical treatments for carpal tunnel syndrome.
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What is the Surgery Timeline?
The typical timeline for carpal tunnel surgery is as follows:
Pre-Operative Consultation: A thorough evaluation by a hand surgeon, including history, physical examination, and possibly imaging or nerve studies.
Day of Surgery: The procedure is performed on an outpatient basis, and the patient is monitored briefly before going home.
Miss Jurga Pikturnaitre, a hand surgeon specialist, before, during and after Carpal Tunnel Release Surgery.
First Week Post-Surgery: Initial recovery with pain management and limited use of the hand.
Two to Six Weeks Post-Surgery: Gradual return to light activities, with potential physical therapy to improve strength and flexibility.
Three to Six Months Post-Surgery: Full recovery, with most patients experiencing significant relief from symptoms.
Find Relief for Carpal Tunnel Syndrome Pain at Emendo Surgical Group
By understanding Carpal Tunnel Syndrome and the available treatment options, including surgery, patients can make informed decisions about their care. If you're experiencing symptoms, our specialist hand surgeon, Miss Jurga Pikturnaitre, is here to help.
Emendo offers Carpal Tunnel Syndrome Release surgery across hospitals and clinics in the South West of England:
Nuffield Health Bristol Hospital
References
American Academy of Orthopaedic Surgeons (AAOS). (n.d.). Carpal Tunnel Syndrome: Overview. Retrieved from orthoinfo.aaos.org
Mayo Clinic. (2023). Carpal Tunnel Syndrome: Treatment. Retrieved from mayoclinic.org
National Institute of Neurological Disorders and Stroke (NINDS). (2020). Carpal Tunnel Syndrome Fact Sheet. Retrieved from ninds.nih.gov
Cleveland Clinic. (2022). Carpal Tunnel Syndrome Diagnosis. Retrieved from clevelandclinic.org
American Society for Surgery of the Hand (ASSH). (2021). Carpal Tunnel Release Surgery. Retrieved from assh.org
MedlinePlus. (2022). Carpal Tunnel Syndrome. Retrieved from medlineplus.gov
Johns Hopkins Medicine. (2023). Carpal Tunnel Release Surgery. Retrieved from hopkinsmedicine.org
NHS. (2023). Carpal Tunnel Syndrome. Retrieved from nhs.uk
British Society for Surgery of the Hand (BSSH). (2023). Carpal Tunnel Surgery Guide. Retrieved from bssh.ac.uk
University of California, San Francisco (UCSF). (2023). Carpal Tunnel Surgery Recovery. Retrieved fromucsfhealth.org
