Nerve Compression

What Is Carpal Tunnel Syndrome?

To fully understand carpal tunnel, it’s important to have a basic understanding of the anatomy of the wrist.

There is a major nerve in the hand called the median nerve. The nerve passes through what is called the carpal tunnel, which is a narrow passageway about one inch wide. This tunnel helps protect the nerve and the tendons that are responsible for bending the fingers and thumb.

When this major nerve is compressed, the resulting pain numbness, burning, and heaviness signifies carpal tunnel syndrome.

Patients most often complain of waking up at night to “shake their hands out,” and may also do this during the day during activities that require gripping and squeezing, such as holding a steering wheel or using a tool.

Can Carpal Tunnel Syndrome Go Away on Its Own?

In some cases, extreme rest for at least two weeks can reduce some of the pain caused by mild cases. Wearing a splint, particularly at night, can help because it keeps your wrist straight and removes pressure from the nerve.

However, in many cases, this only relieves pain temporarily, and it often returns. In fact, it typically gets worse over time.

This is why wrist pain treatment is so vital to helping you return to normal functioning.

What Will Happen If Carpal Tunnel Syndrome Is Not Treated?

Over time, carpal tunnel syndrome usually gets worse, which means it will become more and more difficult to use your hands without having symptoms.

Delaying treatment can make you prone to permanent nerve damage.  Although the painful symptoms may seem to get better if you live with them for many years, this is a sign that the carpal tunnel nerve may be permanently damaged.

How Do You Know if Your Symptoms Are Getting Worse?

If you have any of the following symptoms, it can be a sign that your case is getting worse:

• Reduced grip strength
• Increased pain
• Dropping objects
• Muscle cramping
• Loss of coordination between thumb and fingers (difficulty with buttons)
• Nightly awakenings
• Constant, or nearly constant numbness in the thumb, index, and middle finger

How Is Carpal Tunnel Syndrome Treated?

Treatment depends upon what stage you are in the disease. If caught early, treatments may include:

• Wearing a split (particularly at night)
• NSAIDs, which are anti-inflammatory medications
• Adjusting your activities in order to rest your hand
• Avoiding repetitive motion tasks
• Steroid injections
• Specialized exercises

Do I Have to Have Surgery to Correct Carpal Tunnel Syndrome?

At the Raleigh Bone and Joint Surgery Clinic, we seek conservative, nonsurgical treatments first. We will always work with you to create a treatment plan that addresses your individual situation. It is only when these treatments are unsuccessful that our hand doctors consider surgery.

Often, injections or tests may be performed or ordered at the first visit with your hand doctor to make sure that carpal tunnel syndrome is actually the cause of your symptoms. Injections can provide significant relief, but also can help your surgeon know for sure that you are suffering from carpal tunnel.

What is Carpal Tunnel Surgery Like?

During surgery, we relieve the pressure on the median nerve by releasing the tight ligament that holds the carpal tunnel tightly together. This gently increases the size of this tunnel, and as a result, there is less pressure on the median nerve, which allows the nerve improved blood flow and allows it to once again send signals back and forth. This will provide relief from pain, tingling and numbness, and you will be able to sleep again!

Your hand doctors at The Bone & Joint Surgery Clinic are experts on the most advanced techniques of carpal tunnel release. One of these, called “endoscopic” carpal tunnel surgery, is performed through a tiny poke incision about the size of your pinky fingernail made at the base of your palm. A small waterproof dressing is applied over the site for two days, which is then replaced by a single band-aid. Most patients are able to return to light activities (eating, dressing, computer use) on the day of surgery, and heavy use (tools, lifting weights) after 3 to 5 days.

Generally, we can perform carpal tunnel surgery as outpatient (meaning you go home the same day), and usually medication is given to make the patient sleepy during the procedure. However, patients that would like to remain awake during the procedure and avoid these medications are also free to do so, much like going to the dentist.

What are the Causes?

There is no one issue that causes carpal tunnel syndrome. Rather, it’s a combination of several factors. You may be at risk of developing it if:

• You use your hands repetitively in everyday work (computers, hairdressing, heavy machinery).
• If it runs in your family—some people have a smaller carpal tunnel than others.
• If you’re pregnant—swelling related to hormones can lead to the syndrome.
• You have diabetes.
• You have been diagnosed with a thyroid problem.
• You have rheumatoid arthritis.

Why You Should Trust the Bone and Joint Surgery Clinic in Raleigh for Wrist Pain Treatment

We realize that you have choices when it comes to selecting a hand clinic or a medical home. The Bone and Joint Surgery Clinic has more than five decades of experience in providing the highest level of comprehensive care. In addition, because our surgeons are affiliated with three local hospitals and many outpatient surgery centers, you can select where you would like to have your procedure or surgery.

Whenever possible, we utilize non-surgical options. However, if surgery is needed, our board-certified and fellowship-trained orthopedic surgeons have the expertise needed to help you return to the activities you enjoyed.

Don’t let your carpal tunnel pain gradually get worse. Contact us for the solution you need by easily scheduling an appointment.