Duret Smith, MD
Orthopaedic Surgeon

 

Q. What is carpal tunnel syndrome and how is it treated?

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The carpal tunnel – a narrow, rigid passageway of ligament and bones at the base of the hand – houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed resulting in pain, weakness or numbness in the hand and wrist and eventually radiating up the arm.

Symptoms usually start gradually, with frequent burning, tingling or numbness and typically appear in one or both hands during the night. A person with carpal tunnel syndrome may wake up feeling the need to “shake out” the hand or wrist.

Contributing factors that cause the disorder include trauma or injury to the wrist that cause swelling, such as a sprain or fracture; over activity of the pituitary gland; hypothyroidism; rheumatoid arthritis; mechanical problems in the wrist joint or work stress.

Once diagnosed, treatment should begin as soon as possible under a doctor’s direction. In most cases, the physician will try non-surgical treatments, such as medications and splinting. Anti-inflammatory medications, like aspirin, ibuprofen or prescription pain relievers may ease symptoms that have been present for a short time. Some underlying causes, such as diabetes or arthritis should be treated first before taking prescription drugs. If the problem persists, surgery may be required.

Carpal tunnel release is one of the most common surgical procedures performed in the United States. It is generally recommended if symptoms persist or get worse. The outpatient surgery involves severing the band of tissue around the wrist to reduce pressure on the median nerve and is performed under local anesthesia while the patient is awake.

Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take months. Recurrence of carpal tunnel syndrome following treatment is rare and the majority of patients recover completely.

Dr. Smith is board-certified in orthopaedic surgery and specializes in surgery of the hand. His medical interests include sports medicine and other conditions arising from the workplace. To schedule an appointment with Dr. Smith or any of the outstanding physicians in the Lakewood Hospital physician network, please call our free physician referral service at 1-866-733-6363.