What is the carpal tunnel?
The carpal tunnel is a canal that runs from the wrist to the hand. It is formed by the small bones of the wrist and the transverse carpal ligament across the top of the wrist. The median nerve, which provides sensory and motor functions to the thumb and the middle fingers, also runs through the carpal tunnel.
What is carpal tunnel syndrome?
This condition occurs when the median nerve is compressed as it passes through the carpal tunnel. This compression decreases blood flow to the nerve, which will start to degenerate, and may cause patients to experience many symptoms, including numbness, tingling and loss of hand function.
Although many cases of carpal tunnel syndrome have no known cause, it can be the result of a number of issues:
- Repetitive, small movements of the hands, such as typing.
- Repetitive, grasping movements of the hands, such as engaging in physical activity.
- Joint or bone disease, such as osteoarthritis or rheumatoid arthritis.
- Hormonal or metabolic changes, such as menopause, pregnancy or a thyroid imbalance.
- Injuries to the wrist, such as strains, sprains, dislocation, a break, swelling or inflammation.
Patients with carpal tunnel syndrome may experience some or all of the following symptoms:
- The feeling of “pins and needles" in the fingers, especially at night.
- Numbness of the hand, usually the thumb and three middle fingers, especially at night.
- Difficulty gripping and holding objects.
- A sensation of swollen fingers.
- Relief from the above symptoms by shaking out the hand.
Conservative lifestyle changes will effectively treat carpal tunnel syndrome sometimes, but patients may also need surgery. The UK Hand Surgery Team is well-versed in therapeutic, medicinal and surgical treatment options for patients with this condition. Treatment plans include the following:
- Wrist splints to prevent excess motion and decrease nerve compression.
- Methods to alter the wrist position and wrist usage, such as switching to an ergonomic keyboard when typing.
- Oral or injected anti-inflammatory medication.
- Surgery to remove the source of nerve compression.
Carpal tunnel surgery is an outpatient procedure, which means that patients can return home the day of surgery.
Our expert hand surgeons use local anesthetic to numb an egg-sized area in the front of the wrist. The surgeon will make a 1- to 2-cm incision on the front of the wrist to release the nerve from compression. Then, the surgeon will close the skin with one stitch and wrap the wrist in soft dressings. There is also an option for endoscopic surgery for decompression.
After surgery, it’s important to keep the wrist and fingers moving and elevated to help prevent swelling and stiffness. Patients usually need pain medications and ice therapy for the first two or three days following surgery.
The length of recovery varies depending on both the individual and how long the nerve had been compressed. Stitches are removed after two weeks, at which point patients can resume most normal activities. However, some patients may take up to six months to fully recover.