Carpal Tunnel Syndrome

Carpal tunnel syndrome is characterized by numbness or pain of the thumbs and first two fingers. Although the condition is most commonly seen in females between forty and sixty years of age, it can be seen in adolescents and older people, and especially those who use their hands for extended periods of time doing repetitive tasks. It is also common among carpenters, secretaries, racquetball players, supermarket checkers, assembly line workers, ad knitters. Symptoms most commonly occur at night when reading a book or newspaper. They are usually relieved by vigorously shaking the hand.

What causes carpal tunnel syndrome?

The carpal tunnel or canal is formed by a band or ligament that stretches across the wrist. Nine tendons and the median nerve pass through this tight tunnel. Any swelling of the tendons or decrease in size of this tunnel will result in pressure on the median nerve, and may result in numbness, weakness, or night pain in the wrist and hand. Sometimes the pain may even cause shoulder discomfort.

The treatment of carpal tunnel syndrome begins with a thorough examination and history to make the correct diagnosis. Treatment should be directed at the underlying condition. If carpal tunnel syndrome is a result of a medical problem, the specific treatment should be aimed at that problem, whether it is diabetes or thyroid disease. If the cause is compression on the median nerve due to swelling of the surrounding tendons, then rest, medications, or surgery may be chosen.

Almost everyone with carpal tunnel syndrome of short duration or minimal symptoms should be treated without surgery. Splinting of the wrist and taking anti-inflammatory medicine with meals will result in relief of symptoms in half of the people with this problem. If the carpal tunnel syndrome is a result of unaccustomed use of the wrist or hand, and tendonitis (whether occupational, or athletic) then avoiding or reducing the activity responsible for the numbness will often cause rapid decrease in the symptoms. Injections of anti-inflammatory drugs such as Cortisone are sometimes useful either alone or in combination with other treatments. Remember that any medication you take should be prescribed by a physician and be used with caution.

If relief is not obtained by these conservative methods then surgery may be necessary. This is an operation that "loosens" the wrist ligament, and "opens up" the carpal tunnel and relives the pressure on the median nerve. This surgery is frequently performed as day surgery and done under a local anesthetic. After surgery, a simple wrist splint is worn for two to four weeks.


Fred Creutzmann, M.D - Carrollton, Tx or