Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Simply put, carpal tunnel syndrome is a pinched nerve in the wrist. There is a space resembling a tunnel in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand. This syndrome occurs when swelling in this tunnel puts pressure on the nerve.


Carpal Tunnel Causes

Pressure on the nerve can happen several ways, including:

  • Swelling of the lining of the flexor tendons, called tenosynovitis
  • Joint dislocations
  • Fracture
  • Arthritis
  • Fluid build-up during pregnancy

The scenarios listed above can narrow the carpal tunnel or cause swelling in the tunnel, which are the main cases of carpal tunnel syndrome. Thyroid conditions, rheumatoid arthritis and diabetes can also be associated though, there can be many causes of this condition.


Symptoms of Carpal Tunnel

Symptoms may include:

  • Pain
  • Numbness
  • Tingling
  • Weak grip
  • Occasional clumsiness
  • Tendency to drop things

The numbness or tingling most often takes place in the thumb, index, middle and/or ring fingers. Symptoms are usually felt during the night but may also be noticed during routine daily activities such as driving or reading a newspaper. In severe cases, sensation and strength in the hand may be permanently lost.

When diagnosing carpal tunnel syndrome, Dr. Vangelisti will evaluate your medical history and any prior injuries. An X-ray may also be taken to check for fractures or signs of arthritis.


Carpal Tunnel Treatment

Symptoms of carpal tunnel may often be relieved without surgery. Some treatment options are:

  • Changing patterns of hand use can help to reduce pressure on the nerve as well as keeping the wrists splinted in a straight position.
  • Wearing wrist splints at night can help to relieve symptoms that may prevent sleep.
  • Steroid injections into the carpal tunnel can reduce swelling around the nerve.

When symptoms are severe or do not improve, surgery may be needed to relieve pressure on the nerve. Pressure on the nerve is decreased by cutting the ligament that forms the top of the tunnel on the palm side of the hand. Surgery is most often an outpatient procedure usually performed using a local anesthetic. The procedure usually takes anywhere from 5-20 minutes.


After Carpal Tunnel Surgery

Following surgery it is common to experience some soreness around the incision that may last for several weeks or months. Numbness and/or tingling in the hand may disappear quickly or slowly. Recovery is a process that may take weeks or months. Dr. Vangelisti may also refer you to a hand therapist in order to help your hand regain mobility and to aid in the healing process.

If you are a patient please refer to the “After Surgery Instructions”


Carpal Tunnel Diagram