How to Identify Carpal Tunnel Syndrome

Many think any kind of hand pain is carpal tunnel syndrome. Here, Thesselon W. Monderson M.D., of MUSC Health Orthopaedics in Marion, SC, explains carpal tunnel syndrome, its causes, symptoms, risk factors, and how it’s treated.

What is Carpal Tunnel Syndrome?

Patients often arrive at my office presuming they might have carpal tunnel syndrome. Carpal tunnel syndrome is caused by compression neuropathy (pinched nerve) in the median nerve of the hand. It most often shows up as numbness, tingling, or pain in the hand and forearm.

The condition occurs when one of the major nerves of the hand, the median nerve, is compressed as it travels from the forearm to the hand. The carpal tunnel is the path of the nerve and the tendons that allow your fingers to flex.

If carpal tunnel syndrome is allowed to progress untreated, it can lead to permanent nerve damage. But if diagnosed soon enough it can be treated properly.

The best way to determine if you have carpal tunnel is to get a physical examination, an x-ray, or diagnostic tests such as a nerve conduction study. The nerve conduction study evaluates how the nerve is functioning.

Once diagnosed properly, a course of treatment is prescribed based on the severity of the symptoms.

Common Causes of Carpal Tunnel Syndrome

• Repetitive trauma or overuse
• Systemic disorders such as diabetes and hypothyroidism
• Fractures and other injuries to the wrist

Associated Risk Factors

• Female
• 40 years old, or older
• Pregnancy
• Obesity
• Smoking and high blood pressure

Carpal Tunnel Symptoms

If you are experiencing any of the following symptoms, you might have carpal tunnel syndrome.

• Patients often describe an intense feeling of pins and needles or a burning sensation in their hands or forearm.
• You may also feel numbness in the thumb and first four fingers of the hand.
• Some patients report thumb weakness and accidentally dropping objects from their hands.
• You may have pain at night and difficulty sleeping.
• Sometimes shaking your hand can improve the feeling of numbness and tingling.

Carpal Tunnel Treatment Options

Early symptoms can often be relieved with simple treatment, such as wearing a wrist splint while sleeping. This will reduce pressure on the nerve.

There are also range-of-motion exercises to decrease hand-and-wrist tendon inflammation. It may also be recommended to stop repetitive motion activities such as forceful grasping, pinching or maybe even typing on a keyboard.

Also, it’s important to avoid extreme wrist flexion or extension. A nonsteroidal anti-inflammatory medication may also alleviate the pain. However, it is typically not a long-term solution. A corticosteroid injection may also decrease the inflammation within the carpal tunnel.

When non-surgical treatment options are not successful, it may be necessary to have surgery. A carpal tunnel release procedure is the definitive treatment for this. The surgery can be endoscopic, where small incisions are made, and an endoscope is used to perform the surgery.

The surgery can also be performed using a slightly larger incision of approximately two inches long without an endoscope. Recovery from surgery typically takes four to six weeks before returning to normal activities.

If you would like more information, please feel free to call 843-431-2280 or visit me at MUSC Health – Orthopaedics - Marion Medical Park to schedule an evaluation.