Carpal Tunnel Syndrome Treatment Options

What is carpel tunnel syndrome?

Carpal tunnel syndrome is a common condition that affects the hand and arm, characterized by pain, numbness, and tingling and hand weakness. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist as it passes through the carpal tunnel—a narrow, rigid passageway of ligament and bones at the base of the hand. Swelling in this tunnel can irritate the nerve, leading to symptoms. Symptoms may be worse at night.

Symptoms include:

  • numbness, tingling and pain in the thumb, index finger, middle finger and the thumb side of the ring finger
  • discomfort in the wrist and palm
  • weakness in the muscles of the hand, leading difficulty gripping objects

It is often caused by repetitive work-related activities. Risk factors include diabetes, hypothyroidism, rheumatoid arthritis, obesity, and pregnancy.

Treatment typically consists of nonsurgical methods and surgical release.

Nonsurgical Treatments

  • Wrist Splinting: A splint that holds the wrist still while sleeping can help relieve nighttime symptoms of tingling and numbness.
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Oral pain medications like ibuprofen can help relieve pain and reduce inflammation.
  • Topical pain medication: Topical menthol ointment or topical anti-inflammatory medication may help to reduce pain.
  • Rest: Keeping the wrist straight can help relieve pressure on the nerve.
  • Staying warm: Keeping the hands warm can help with pain and stiffness.
  • Activity Changes: Avoiding activities that make the wrist flex and worsen symptoms and making ergonomic adjustments to workspaces can be beneficial.
  • Physical therapy: Specific exercises called Nerve Gliding exercises can help the median nerve move more freely within the confines of the carpal tunnel. Another exercise is a wrist exercise that can help relieve pressure on the nerve by making a fist and then stretching the fingers straight.
  • Icing: Icing can reduce swelling and numb pain.
  • Corticosteroid Injections: Injecting a corticosteroid, such as cortisone, into the carpal tunnel can reduce pain and swelling.
  • Ultrasound Treatments: Applying high-frequency sound waves at the inflamed area can accelerate healing of damaged tissues.
  • Alternative Medicine:
    • Acupuncture is an alternative therapy that may help treat the nerve pain of carpel tunnel syndrome.
    • Yoga
    • Chiropractic manipulation
    • Vitamin B6 supplements

When symptoms are severe and nonsurgical treatments have not helped, surgery may be recommended.

Surgical Treatments

Carpal tunnel release surgery is the most common surgical procedure for treating carpal tunnel syndrome. This surgery involves cutting the ligament that forms the roof of the carpal tunnel to reduce pressure on the median nerve.

There are two main types of surgery:

  • Open Release Surgery: This involves a single, small incision on the palm and cutting through the ligament that is causing the pressure. As you heal the new ligament tissue grows back but with more room for the nerve.
  • Endoscopic Surgery: Involves one or two smaller incisions and the use of a tiny camera to guide the surgeon. The surgeon cuts the ligament that is causing the pressure.

After surgery, the patient may experience pain, swelling, and stiffness in the hand. Rehabilitation exercises or physical therapy can help speed up the recovery process. Complete recovery from surgery can take months, and the patient may be advised to avoid or modify the activities that contributed to the condition.

Carpal tunnel syndrome is a condition that can significantly impact daily activities and quality of life. A combination of lifestyle changes, medical management, and potentially surgery can effectively manage and treat carpal tunnel syndrome. Early diagnosis and intervention are crucial to prevent permanent nerve damage and worsening symptoms.

When you or a loved one suffers with hand and finger pain, contact Dallas Neurological and Spine to schedule an appointment to receive the correct diagnosis and all your treatment options. You will always be treated with respect and dignity.

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