What is carpal tunnel syndrome?
Carpal tunnel syndrome is a painful medical condition caused by the nerve and tendon inflammation in the passageway on the palm side of the wrist. Carpel tunnel is the name of this narrow passageway through which the median nerve runs up to the hand and fingers. There also tendons in the tunnel covered by bones and sheath. Any inflammation in the carpel tunnel causes space crunch and the median nerve is trapped or squeezed. This leads to the feeling of pain, numbness and weakness in fingers and parts of the hand fed out by the median nerve.
How does carpal tunnel syndrome occur?
The median nerve and nine other flexor tendons pass through the carpal tunnel surrounded by bony structures on three sides and a ligament above. When there is swelling or inflammation in tendons, the median nerve is squeezed or entrapped in the carpal tunnel. The nerve becomes irritated as it is constricted and prevented from carrying sensation and impulses to muscles in the palm and finger bases. Gradually pain, weakness and other symptoms become visible and the patients is diagnosed with carpal tunnel syndrome.
What are signs and symptoms of carpal tunnel syndrome?
Patients feel a number of symptoms, as they suffer from carpal tunnel syndrome. This may include
- pain and weakness in hand and fingers
- pain spreading to forearm
- weakness in holding an object with a firm grip
- numbness, tingling or electric shock sensation in upper extremities
- weakened thumb muscles
- symptoms worsen at night
What are causes of carpal tunnel syndrome?
The primary cause of the carpal tunnel syndrome is the inflammation or compression of the median nerve. The following are some major factors contributing to the disorder.
- Swelling or inflammation in flexor tendons
- Wrist injury impacting the tunnel structures
- Synovial tissue inflammation
- Sheath/ ligament injury
- Carpal tunnel congenital deformity
- Wrist sprain or fracture
Who are at enhanced risk of carpal tunnel syndrome?
People with diabetes, thyroid disorder, obesity or working on packing units are at the enhanced risk of carpal tunnel syndrome. The disorder is also common to impact musicians and those working on computers for long hours.
How is carpal tunnel syndrome diagnosed?
- Physical examination of symptoms
- Analysis of active and passive motion of hand and fingers
- Checking the reaction of the median nerve to pressure
- Wrist x-ray
- Electrophysiological study of the median nerve function
What are available methods to treat carpal tunnel syndrome?
- Self-care: Rest and use of ice therapy may reduce inflammation of flexor tendons.
- Medication: Doctors prescribe anti-inflammatory medication to treat inflammation and swelling inside the carpal tunnel. It eases pressure on the median nerve.
- Orthopedic devices: Patients use brace or splint to keep the wrist free stress and prevent its curling so that the inflammation of flexor tendons subsides and the nerve is not compressed.
- Corticosteroid injection: Steroid injected into the carpal tunnel treats inflammation and inhibits pain on semi-permanent basis. Trials show about 70 to 80 percent success in relieving pain and other symptoms over a period of six months.
Commonly known as carpal tunnel release, the surgery helps widen the tunnel and create additional space to relieve pressure on the compressed medial nerve. The surgical method is the best possible way to treat the problem successfully and for long term relief.
What is carpal tunnel release?
Carpal tunnel release involves bifurcation of the lower side of the ligament that constitutes the roof of the passageway. It loosens the tight sheath connecting bony structures on two sides and allows the nerve and tendons to move without compressing each other. Thus the nerve entrapped in the passageway is released and does not have to endure pressure from bones, tendons or other elements in the tunnel.
Who is a candidate for carpal tunnel release?
A suitable candidate for carpal tunnel release surgery must have
- severe symptoms of carpal tunnel syndrome
- no relief from non-surgical treatments
- overall good health
- pain and functional impairment from the carpal tunnel syndrome continuing over six months
- considerably decrease in the ability to grasp objects by hand
- changes in wrist and hand muscles
- chronic medial nerve compression
Is anesthesia required for carpal tunnel release?
Doctors use local or general anesthesia depending on the need.
How is carpal tunnel release performed?
A carpal tunnel release can be performed using two different techniques.
- Open release method, where an open incision is made on the palm side of the wrist to observe and cut the transversal ligament making the roof of the tunnel. This reduces pressure in the tunnels as the roof opens up and relieves the entrapped median nerve.
- Endoscopic release method, where the carpal ligament is cut using endoscopic procedure. Two tiny incisions are made on the forearm side to put through endoscopic equipment and cut the ligament without opening the skin above the tunnel.
How long does carpal tunnel release take?
It takes about 30 to 60 minutes depending on which procedure is performed.
Which type of carpal tunnel release is the best?
Endoscopic carpal tunnel release is considered better than open surgery as it is less invasive and offers faster recovery. There is no scarring and negligible chance of complications. However, not all patients are suitable for endoscopic procedure.
A knife-like instrument is also inserted to dissect the carpal ligament from inside without violating the skin of the palm. This loosens roof pressure on the tunnel and relieves the medial nerve from being squeezed. The skin incision is stitched.
How long is the recovery period?
Patients return to normalcy within six weeks. The pain relief is immediate, though it is not felt until properly until 2/3 weeks, as soreness caused by the surgery remains apparent. The recovery can be faster with light activities, finger movements, soft tissue massage and avoidance of stressful work and grasping.
Colorado Clinic offers comprehensive nonoperative treatment for carpal tunnel syndrome at several pain clinic locations in Greeley, Loveland, Boulder, Longmont and Buena Vista. Call today for top treatment in Colorado with Board Certified providers!