 |
|||||||||||||||||
 |
|
 |
|||||||||||||||
 |
|||||||||||||||||
|
What is Carpal Tunnel Syndrome? Carpal tunnel syndrome causes numbness or tingling in the thumb, index, and middle fingers. It often involves both hands, and can be associated with cubital tunnel syndrome which causes numbness in the small and ring fingers. It can wake you up at night with burning and pain. Late findings include dropping objects and wasting in the thumb muscles. Carpal tunnel syndrome is very common, but it is important not to confuse it with other medical problems such as tendonitis, arthritis, or overuse syndrome. The carpal tunnel is a space in the wrist where the median nerve and 9 tendons pass. It is bound by bones on 3 sides and the transverse carpal ligament. Anything that increases swelling within the tunnel can increase pressure on the median nerve and inhibit blood flow, and lead to injury. Severe damage can cause weakness in the thumb muscles over time. Risk factors include age over 50, female gender, and pregnancy. Underlying medical problems can also be a risk factor including diabetes, hypothyroidism, rheumatoid arthritis, and fractures. Exposure to vibration and repetitive motion can exacerbate symptoms. How is carpal tunnel syndrome treated? The first line of treatment involves wearing carpal tunnel splints while sleeping at night. These can be obtained at a local pharmacy or medical supply store, and hold your wrist straight while you sleep at night. Activity modification can help also, such as avoiding vibration If splints do not improve symptoms, I recommend you consult a hand surgeon to ensure the correct diagnosis is found. A cortisone injection can be helpful in relieving symptoms, but can be temporary. Change in diet, medications, or physical therapy has limited benefit for most people.
Carpal tunnel splint
Is surgery needed? Surgery involves an outpatient procedure in an operating room. I usually perform the surgery under sedation (like a colonoscopy), but other options are available including local anesthesia. The surgery releases the transverse carpal ligament, thereby increasing the volume of the carpal tunnel and decreasing pressure on the median nerve. Results are very successful, but can be affected by many factors such as nerve damage and age. Surgery has excellent results in properly selected patients, the key is to have the correct diagnosis.
Endoscopic carpal tunnel release I use a single incision at the wrist, and no cast or splint. Immmediate light use of the fingers is allowed. Typically there is decreased pain in the first 2 months with the endoscopic technique versus the mini-open, but after this period results are very similar. I offer both open and endoscopic surgery in my practice.
Endoscopic (left) and open (right) carpal tunnel release incisions For appointments call 925-939-8585 |
 |
 |
|
| Site Map |