What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is a common condition that causes numbness, tingling, and pain in the hand and forearm. The condition occurs when one of the major nerves to the hand—the median nerve—is squeezed or compressed as it travels through the wrist.
The carpal tunnel is a narrow passageway on the palm side of your wrist made of bones and ligaments. When this area becomes narrowed or the tissues surrounding the flexor tendons swell, it puts pressure on the median nerve, leading to the characteristic symptoms.
How is Carpal Tunnel Syndrome Diagnosed?
Diagnosis typically involves a combination of medical history, physical examination, and diagnostic testing:
- Physical Exam: Your doctor will test the sensation in your fingers and the strength of the muscles in your hand. Specific tests like the Phalen’s maneuver or Tinel’s sign may be used to provoke symptoms.
- X-rays: While X-rays don’t diagnose CTS, they can rule out other causes of wrist pain, such as arthritis or a fracture.
- Electromyogram (EMG) and Nerve Conduction Studies: these tests measure the electrical activity in muscles and the speed of nerve impulses to confirm nerve compression and its severity.
Management and Treatment
Nonoperative Management
For many patients, especially those with mild to moderate symptoms, non-surgical treatments can provide significant relief:
- Wrist Splinting: Wearing a brace at night can help keep the wrist in a neutral position, relieving pressure on the nerve during sleep.
- Activity Modification: Avoiding repetitive motions or positions that aggravate symptoms.
Operative Management
If nonoperative treatments do not provide relief or if there is evidence of nerve damage, surgery may be recommended. The goal of surgery is to relieve pressure by increasing the size of the carpal tunnel.
- Carpal Tunnel Release: This is one of the most common surgical procedures performed by Dr. Tantone. During surgery, the ligament that forms the roof of the carpal tunnel is cut, which decreases pressure on the median nerve.
- Recovery: Most patients experience significant improvement shortly after surgery, though full recovery of strength and sensation can take several months depending on the severity of the initial nerve compression.