What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome happens when the median nerve of the wrist is compressed in the carpal tunnel at the base of the hand. The median nerve is responsible for providing motor and sensory function to our thumb and three fingers of the hand. When it gets compressed by the carpal tunnel, its functions are impeded and you start getting symptoms of carpal tunnel syndrome. Symptoms include numbness, pain, and tingling sensation in the hand and arm.
Carpal tunnel syndrome is a fairly common condition. As it involves compression of one of the major nerves of the hand, the condition has a huge impact on the functioning of the hand itself. Carpal tunnel syndrome gets worse with time, which makes an early diagnosis and treatment quite necessary. When the symptoms are mild, simple measures and precautions like wearing a splint and avoiding activities that involve extreme movements of the wrist can provide some relief. But if the pressure on the median nerve sustains, it can worsen symptoms and lead to severe nerve damage. Carpal tunnel release surgery is the most successful solution for carpal tunnel syndrome. The surgery has proven effective in eliminating all symptoms of the condition and avoiding any damage to the median nerve.
Carpal Tunnel Syndrome Symptoms and Causes
- Small, repetitive movements of the hand like typing or using the keyboard
- Degenerative conditions like arthritis, osteoarthritis, and rheumatoid arthritis
- Repetitive grasping movements of the hand, such as in and sports and physical activities
- Activities that involve extension and flexion of the hand and wrist for a prolonged time
- Hormonal changes during pregnancy
- Thyroid gland imbalance or Type 2 diabetes
- Family history of carpal tunnel syndrome
- Accidental injuries like sprain, dislocation, fracture, swelling, and inflammation of the wrist
- Weakness of the affected hand
- Numbness and pain in the hand and wrists, which becomes more severe at night
- Tingling and burning sensation in the thumb and fingers
- A feeling of swelling in the fingers in the absence of swelling
Carpal Tunnel Diagnosis
Physical exam and tests for Carpal Tunnel Syndrome
During the physical exam for carpal tunnel syndrome, your doctor will ask you questions about your symptoms, medical history, occupation, and general health. Your affected hand and wrist will be carefully examined with the help of several tests. During the tests, the doctor may do one or all of the following things.
- Tap along or press down the median nerve at the inside of your rest to see if any numbness or tingling is caused.
- Bend and hold your wrist in a flexed position to check for tingling and numbness in your hand.
- Lightly touch your fingers with a special instrument when your eyes are closed to check the sensitivity in your fingertips
- Check for muscle atrophy at the base of your thumb
- Check for the weakness of the muscles at the base of your thumb
After a physical exam, some tests are performed to ascertain the extent of the condition and the damage to the median nerve. Some of the tests that may be performed and listed as follows
- Nerve conduction test: A nerve conduction test measures the signals that travel and your nerves. This test can detect if your median nerve is not conducting its signal properly and can help your doctor to a certain extent of median nerve damage.
- Electromyogram or an EMG: An electromyogram measures the electrical activity in the muscle and shows the extent of muscle and nerve damage.
- X-rays: X-rays are perfect for obtaining images of dense structures like bones. If you have limited function of the wrist and experience pain in movements, your doctor can order an x-ray to exclude any other causes for your symptoms like arthritis, fracture, or ligament injury.
- Magnetic resonance imaging or an MRI: MRI scans provide a better image of soft tissues. An MRI can help your doctor to determine any other causes for your condition and can help him look for abnormal tissues which might be affecting the median nerve. It can also help the doctor to determine if there are any problems with the nerve itself, like an injury, tumor, or scarring.
Self-diagnosis for carpal tunnel syndrome
Keep your hand straight and use the fingers of your opposite hand to lightly tap the skin over your wrist-crease. Tap left to right and repeat this a few times. Observe if you get a tingling or a burning sensation in your hand.
Risks & Complications Associated With Carpal Tunnel Syndrome
Risk Factors
- Anatomic factors: Arthritis and accidental injuries like fracture or dislocation of the wrist can increase the pressure on the median nerve.
- Nerve damaging conditions: Conditions like diabetes promote nerve damage, including the median nerve, and can contribute to carpal tunnel syndrome.
- Inflammatory conditions: Rheumatoid arthritis affects the lining of tendons in the wrist and increases pressure on the median nerve, and adds to the severity of symptoms.
- Gender: Carpal tunnel syndrome is more common in women as carpal tunnels of women are smaller than those of men in most cases.
- Obesity: Being overweight and obese is considered a potential risk factor for carpal tunnel syndrome.
- Changes in body fluids: Fluid retention in the body increases the pressure on the carpal tunnel, which irritates the median nerve. This happens commonly during pregnancy and menopause.
- Workplace factors: Working in an assembly line, or in a job that requires repetitive motions of the hand and wrist, or prolonged extension and flexion of the wrist are harmful to the median nerve. Such factors can be responsible for carpal tunnel syndrome and cause severe damage to the median nerve.
What would happen if carpal tunnel syndrome is not treated?
Many people ward off the symptoms of tunnel syndrome as something which is not serious and don’t even get a proper diagnosis. But if carpal tunnel syndrome is left untreated, it leads to a lack of coordination, weakness, and permanent nerve damage in the hand. If you feel like you have symptoms of tunnel syndrome and it has begun disrupting your routine life, make an appointment with an orthopedic doctor as early as possible. Most people tend to wait until the symptoms become too severe, which can lead to irreversible nerve damage. If the condition is addressed in time, it can be successfully treated with the help of carpal tunnel release surgery, provided that it’s not done too late.
Questions to ask your doctor
- Why do I need carpal tunnel release surgery?
- Are there any other conservative treatment options for treating carpal tunnel syndrome?
- How long does the surgery take?
- When will I be discharged?
- What precautions and instructions do I have to follow after the surgery?
- When can I return to my routine life and work?
- Will I need assistance at home after the surgery?
- What medications will I have to take?
- What type of physical therapy and exercises would I require?
- How often would I have follow-up appointments?
- How can I contact you in case of an emergency?
Treatment options & cost Carpal Tunnel Syndrome
Treatment of carpal tunnel syndrome
After your physical examination and tests, your doctor will determine the extent of your condition, and formulate a treatment plan for you. Carpal tunnel syndrome can be treated in surgical and non-surgical ways. However, the type of approach adopted by the doctor depends on the severity of the symptoms.
Nonsurgical treatment for carpal tunnel syndrome
If you are still in the beginning phase of carpal tunnel syndrome, conservative treatment options may help in controlling pain and numbness in your hand. Some non-surgical treatment options for carpal tunnel syndrome are listed below.
- Wearing a splint, especially at night
- Taking prescribed non-steroidal, anti-inflammatory drugs like Ibuprofen
- Taking cortisone injections
Under the conservative approach for treating carpal tunnel syndrome, you will also have to make some adjustments in your lifestyle. Your doctor may recommend you move your computer keyboard at work to a more comfortable position or to adjust the height of your chair. Along with this, some exercises may be suggested to relieve your symptoms
It should be noted that the rate of success of nonsurgical treatment for carpal tunnel syndrome varies from person to person. It can show results only if the condition is in its beginning stages only. But if the condition has progressed, carpal tunnel release surgery is the only solution that can successfully rid of your symptoms.
The need for the surgery depends on the severity of symptoms, namely how much pain and numbness do you have in your hand. In long-standing cases where the condition has progressed, constant pain is felt in the hand and fingers, and the thumb muscles are wasted away. In such cases, carpal tunnel release surgery is recommended to avoid permanent damage.
If you have undergone an open carpal tunnel release, the recovery time will be longer, and it will take a few weeks before you can return to your routine life.
However, if you choose an endoscopic carpal tunnel release, the recovery period will be significantly shorter. The pain and uneasiness fade out immediately after the surgery. You will discharge the same day of the surgery or the next day at max. Before your discharge, your doctor will explain to you the precautions you’ll need to take during the recovery period. After a couple of weeks, you will be able to do our routine work and life, provided that you follow all instructions and attend all follow-up appointments.
Insurance coverage
Most health insurance policies in India typically cover the cost for carpal tunnel release surgery. But the exact amount of coverage depends on the individual’s particular insurance policy. Carpal tunnel surgery is usually recommended when a person has severe stage carpal tunnel syndrome, has severe pain, dumbness among other symptoms, and when all nonsurgical treatments (including medications, rest, steroid injections, etc) have failed.
Recovery rate
After a carpal tunnel surgery, you may experience soreness around the incision that may last for a few days. You will be advised to rest your operated hand and to avoid lifting heavy objects or gripping strongly. Apart from that, there are no specific restrictions on activities after the surgery. Numbness and tingling will disappear after the surgery and strength in the hand and wrist would return to normal.
If carpal tunnel surgery is performed on your dormant hand and you do not do repeated hand or wrist actions at work, you may be able to return to work in 7 to 10 days. Patients who undergo endoscopic carpal tunnel surgery are able to return to work much sooner than with open carpal tunnel surgery. However, as with all surgeries, specific recovery time and results vary from patient to patient.
Facts and statistics around Carpal Tunnel Syndrome
Why choose Pristyn Care for your carpal tunnel release surgery?
At Pristyn Care, you can meet the best surgeons for your carpal tunnel treatment and can discuss with them how a carpal tunnel release surgery can benefit you and why it is suitable for your specific needs and lifestyle. We have a team of highly skilled surgeons and hand surgeons who provide comprehensive care and treatment for patients who suffer from orthopedic conditions such as carpal tunnel syndrome, ACL tear, osteoarthritis, rheumatoid arthritis, or other orthopedic conditions. You can make your appointment with one of our orthopedic surgeons at the date and time convenient for you.
