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Carpal Tunnel Syndrome (CTS)

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carpal tunnel

Carpal tunnel syndrome (CTS) is caused by the compression of the median nerve as it travels through the wrist. Symptoms include pain, numbness, and tingling in the hand (usually on the palm and palmer side of the first three fingers from the thumb), a weak grip, decreased dexterity, feelings of hand swelling and atrophy of muscles in the hand. Symptoms tend to be worse at night and can affect anywhere from the arm up to the shoulder.

Some of the common causes and predisposing factors for carpal tunnel syndrome include: diabetes, rheumatoid arthritis, repetitive strain of the wrist (from activities such as typing, reading, driving, etc.), wrist fracture and associated swelling, pregnancy, oral contraceptive use leading to swelling of the limbs, and having an underlying nerve dysfunction.

A physician will perform a number of physical maneuvers and nerve conduction studies before diagnosing a patient with Carpal Tunnel Syndrome. If the doctor does diagnose the patient with Carpal Tunnel Syndrome, there are a number of treatments to examine before surgery is considered. These include: yoga, deep pulsed ultrasound, glucocorticoid medication taken orally or injected, wrist splints and minimizing contributory factors and carpal tunnel injections with a combination of local anesthetics and steroid. If symptoms continue without improvement for six months while conservative treatments are tried, surgery is usually the next step in helping the patient find relief.

The definitive treatment is surgical decompression of the median nerve, which can be done via open incision or endoscopically.  A minority of patients, especially those with advanced carpal tunnel syndrome, will not find relief after the surgery. The best Carpal Tunnel Syndrome treatment is prevention by reducing repetitive movement of the wrist and by keeping it in a neutral position as often as possible.

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