What is Carpal Tunnel Syndrome (CTS)?
In the center of the wrist, there is a space called the carpal tunnel where a major nerve (the median nerve) and nine tendons pass from the forearm into the hand. A very strong ligament forms a roof over the tunnel. When there is swelling in the carpal tunnel, pressure is put on the median nerve, which supplies most of the fingers and thumb with feeling and movement. When pressure becomes great enough to compress the nerve, Carpal Tunnel Syndrome (CTS) may occur.
Causes and Symptoms
The most common causes of CTS are swelling of the lining of a tendon, repetitive use of hands involving activities such as grasping, squeezing or clipping. Other causes include fluid retention during pregnancy, rheumatoid arthritis and bone dislocations or fractures. Symptoms such as pain, numbness and tingling may result, either by itself or in combination on either or both hands. They may also be noticeable while performing daily activities like reading, driving, and doing household chores. A weakening of the grip may become apparent, along with a tendency to drop objects.
We suggest the following non-surgical treatment to relieve pressure on the median nerve:
- Cut down on activities that cause continuous exertion or repetitive use of your hands, or keep the wrist in a neutral position may help reduce the wiring within the carpal tunnel and relieve pressure from the nerve area.
- Wearing wrist splints at night may relieve the symptoms and accomodate a better night's rest.
- Anti-inflammatory medication taken orally or injected into the carpal tunnel may help reduce the spelling and relieve symptoms.
When symptoms are severe or do not improve with non-surgical treatments, surgery may be elected to enlarge the carpal tunnel by cutting (releasing) the ligament to allow more room for the median nerve. Endoscopic surgery is now available and this form of surgery shortened the recovery period as compared to open surgery. While individual results vary, most patients return to normal daily activities within days after endoscopic surgery and return to work earlier than those who undergo the open surgery. The Endoscopic surgery procedure is performed using a device called the Carpal Tunnel Release System. It allows the release of the carpal ligament through a small incision at the base of the wrist. Carpal tunnel release has been proven to be a highly successful surgery with excellent results for most patients.
Dr Jonathan Lee