Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common condition in which one of the major nerves to the hand (the median nerve) is squeezed or compressed as it travels through the wrist. This can cause pain, numbness, tingling, or weakness in the hand and arm. Treatment for carpal tunnel syndrome can ease symptoms and ranges from conservative to surgical options.
Symptoms of carpal tunnel syndrome include:
- Tingling or numbness in the wrist, hand, and fingers (except the little finger)
- Weakness in the hand that may affect grip
- Tingling sensation that may travel from the wrist up the arm
- Numbness may be constant
- Symptoms may worsen while gripping or holding items
Treatment for carpal tunnel syndrome includes preventive methods, at-home lifestyle modifications, and sometimes surgery. When addressed early, conservative treatments are often all that is necessary to resolve symptoms of carpal tunnel syndrome.
- Lifestyle Modifications: Many patients experience symptom relief with lifestyle modifications. For example, take more frequent breaks to rest and stretch the hands, reduce or avoid movements that make symptoms worse, apply cold packs, squeeze a rubber exercise ball several times a day, avoid holding objects in one position for a long time, quit smoking, and maintain a healthy weight. When working at a computer, keep your hands and wrists in line with your forearms, and consider switching hands when using a computer mouse. Yoga has also been shown to ease carpal tunnel symptoms.
- Stretches and Exercises: Various stretches and exercises can help to relieve symptoms. Wrist rotation in each direction, individual finger stretches, prayer stretch, wrist flexor stretch, and wrist extensor stretch can all help with carpal tunnel syndrome.
- Wrist Splints: Wearing a splint on the wrist at night can help relieve nighttime symptoms that wake you from sleep. It can also help prevent daytime symptoms and is a good treatment option for patients who cannot take medications.
- Medications: Non-steroidal anti-inflammatory medications, as well as prescribed corticosteroids, can decrease inflammation and swelling.
- Injections: Corticosteroids may also be administered as injections to relieve pain from carpal tunnel syndrome.
- Surgery: Carpal tunnel surgery may be appropriate if symptoms are severe or if they don’t respond to conservative treatments. Surgery involves cutting the ligament that presses on the median nerve. Conservative treatments are usually attempted before surgery is considered.
Frequently Asked Questions
Carpal tunnel syndrome is caused by pressure on the median nerve, which runs through the wrist into the hand. It is often caused by repeated hand motions used in work and various hobbies and sports. It can also be caused by pregnancy, diabetes, arthritis, lupus, hypothyroidism, or multiple sclerosis.
To prevent carpal tunnel syndrome, adopt the following habits:
- Take more frequent, short breaks (every 10 to 15 minutes) to rest and stretch the hands.
- Reduce or avoid movements that make symptoms worse.
- Squeeze a rubber exercise ball several times a day.
- Avoid holding objects (such as a book or phone) in one position for a long time.
- Wherever possible, grip objects with your full hand instead of just your thumb and index finger.
- When working at a computer, keep your hands and wrists in line with your forearms, and hold your elbows close to your sides.
- Switch hands with repeated movements (such as using a computer mouse).
- Rotate your wrist up, down, and from side to side. Do each movement slowly, then relax. Repeat.
- Pull back on your fingers and thumb to stretch them far apart from each other, then relax them. Repeat.
- Do the prayer stretch: Hold your palms together just below your chin, then slowly lower your hands toward your waist to stretch the forearms. Hold this stretch for a few seconds, then release. Repeat.
- Do the wrist flexor stretch: With your arm extended in front of you and palm facing upward, use your other hand to slowly bend your fingers downward toward the floor. Hold this stretch for a few seconds, then release. Repeat.
- Do the wrist extensor stretch: With your arm extended in front of you and palm facing downward, use your other hand to slowly bend your fingers downward toward the floor. Hold this stretch for a few seconds, then release. Repeat.
- Get treatment for conditions that can cause carpal tunnel syndrome, such as diabetes, arthritis, lupus, hypothyroidism, or multiple sclerosis.
Surgery is usually only performed when symptoms of carpal tunnel syndrome are so bad that they limit your activities even after weeks or months of other treatments.
The recovery after carpal tunnel surgery varies depending on the details of your procedure. Your orthopedic surgeon will provide you with more information before you undergo your procedure so that you can be prepared.
For most patients, surgery will provide sufficient relief of symptoms from carpal tunnel syndrome. For severe cases, surgery will usually improve symptoms, but mild symptoms may remain.