What is carpal tunnel syndrome?

The carpal tunnel is a narrow passageway on the palm-side of the hand that is surrounded by ligaments and bones. The median nerve, one of the major nerves within the hand, travels through the carpal tunnel. Carpal tunnel syndrome is marked by pain, numbness and tingling in the hand and arm, and is caused when the median nerve is compressed or pinched in the wrist. The orthopedic experts at BICMD can diagnose carpal tunnel syndrome and can offer expert advice and a second opinion about the treatment options available for your individual hand and wrist condition.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is when the tunnel that the median nerves travels through becomes narrowed and causes compression on the nerve. This can occur when the tissues, called synovium, surrounding the flexor tendons in the wrist, swell and narrow the space. In a healthy wrist, the synovium lubricates the tendons, making it easier to move the fingers. However, when the synovium swells, it crowds the nerve and places abnormal pressure on the median nerve. This creates numbness, tingling and weakness in the hand. Some of the most frequent health conditions that can cause the synovium to swell are:

  • Diabetes
  • Thyroid dysfunction
  • Trauma to the wrist or wrist fractures
  • Rheumatoid arthritis or other auto-immune diseases
  • Fluid retention

Carpal tunnel syndrome can also be caused by:

  • Repetitive hand motions which aggravate the tendons in the wrist
  • Hand positions that are extreme – over extension or flexion for long periods of time can increase pressure on the median nerve.
  • Heredity – It the carpal tunnel is more narrow than normal

What are the symptoms of carpal tunnel syndrome?

Individuals who have carpal tunnel syndrome report one or more of the following symptoms:

  • Numbness, tingling, burning or pain – often in the thumb, and fingers
  • Pain in the wrist, especially the palm-side
  • Pain that may travel up the wrist to the shoulder
  • Weakness when gripping objects
  • Stinging sensation, or feeling “pins and needles” in the fingers
  • Pain at night that interrupts sleep
  • Deep throbbing or ache in the wrist

How is carpal tunnel syndrome diagnosed?

The experts at BICMD will obtain a detailed medical history that includes the onset of symptoms and the severity of pain or numbness. An x-ray may be used to rule out bone abnormalities but are not used to diagnose carpal tunnel syndrome. Instead, our specialists may request an EMG (Electromyogram) that measures the amount of electrical activity in the muscle. An EMG will check for nerve and/or muscle damage. An ultrasound may be used to check the median nerve for signs of compression. Our doctors can offer a second opinion and can give expert advise for the type of treatment you should seek for the best possible outcome.

What is the treatment for carpal tunnel syndrome?

Non-surgical treatment:

  • Anti-inflammatory medication such as NSAIDs or ibuprofen to manage pain
  • Splinting – keeps the wrist from moving and eases the compression of the nerve
  • Work changes – discontinuing the same motions that cause pain, numbness or tingling
  • Strengthening exercises – should be supervised by one of our expert physical therapists
  • Corticosteroid injections

Surgical treatment:

We highly recommend a second opinion of your carpal tunnel syndrome before undergoing a surgical procedure. Our expertly trained physicians can explain the risk and benefits for the following possible surgical procedures:

  • Endoscopic Carpal Tunnel Release
  • Open Carpal Tunnel Release

For more information about carpal tunnel syndrome and the treatments available, or if you would like to receive an expert consultation about your hand and wrist pain, please contact our specialists, by clicking on “Connect With a Doctor.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.