Carpal Tunnel Syndrome
Carpal Tunnel Syndrome Diagram
Carpal Tunnel Syndrome is a Common Problem
It is so common that Carpal Tunnel Syndrome is seen in almost every orthopedic surgeon's practice.
Carpal Tunnel Cause
The carpal tunnel is a narrow passage in the wrist where the median nerve passes. The top of the passage is covered by strong soft tissue called the transverse carpal ligament. The median nerve provides sensation to the thumb, index, middle and half of the ring finger. It also controls muscles in the hand as well. Carpal tunnel syndrome occurs when the tissue in the wrist swells and puts pressure on the median nerve in the tunnel. There are a number of causes: overuse of the wrist and hand, after trauma to the wrist and diabetes to just name a few.
Carpal Tunnel Symptoms
Patients will usually complain of pain and numbness in the hand. These symptomswill often awaken the patient at night causing them to shake their hand. Pain may radiate up the arm to the shoulder. The numbness usually involves all or part of the hand except the little finger. Over time with progression there can be weakness and atrophy of the muscles at the base of the thumb.
Carpal Tunnel Diagnosis
Patients should see their doctor who will take a history and examine the hand and wrist . There are several specific tests that are done during the exam to determine if there is indeed carpal tunnel syndrome. If the symptoms have been present for a month or longer then an electrophysiological test called an EMG is done to document the pathology. It will often assist in what treatment is recommended.
Carpal Tunnel Treatment
After a diagnosis of carpal tunnel is made a decision on the best way to treat it is made between the doctor and patient. In almost all instances conservative therapy which involves a wrist splint is indicated. Non-steroidal anti-inflammatory medication is used as well. Patients may need to alter their activity if it is determined that it is the cause.
If a patient fails to improve with conservative treatment of rest, splinting and medication then surgery is an option. The technique involves cutting the transverse carpal ligament through a small wrist incision. Afterwards the patient is usually placed in a splint for a week to 10 days. This is a short outpatient procedure and most patients recover quickly and can resume activities with two to three weeks.