Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a condition affecting the nerve that controls sensation and movement in your hand. CTS is the most common form of entrapment neuropathy, where peripheral nerves are compressed or squeezed. 

In the United States, CTS affects 1-5% of the population, with a higher incidence in females. It can impact one or both wrists. 

Without proper treatment, CTS can significantly impact your life, causing severe damage to the median nerve. This can result in permanent numbness and lasting weakness in affected muscles.

At Kimball Health Services, we offer personalized diagnostic care and both non-surgical and surgical treatments for your condition. If you're experiencing pain in your wrist, schedule an appointment for comprehensive and tailored care.

The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand. The median nerve travels from the cervical spine through this tunnel. It provides sensation to the thumb, index, middle, and part of the ring finger (excluding the little finger). 

Carpal tunnel syndrome occurs when the median nerve is compressed or squeezed at the wrist. This compression may cause numbness, weakness, and pain in your hand and wrist. Additionally, swelling in the fingers can limit their functionality.

Certain health conditions and hand and wrist activities elevate the risk of developing carpal tunnel syndrome. 

Repetitive hand and wrist motions that can place people at risk of developing carpal tunnel syndrome involve:

• High-force actions like hammering
• Extreme wrist motions
• Activities that involve constant vibrations, such as operating jackhammers or chainsaws

Health conditions contributing to the development of carpal tunnel syndrome include:

• Genetics (it runs in families)
• Pregnancy
• Hemodialysis
• Wrist fractures and dislocations
• Hand or wrist deformities
• Arthritic diseases
• Thyroid hormone imbalance
• Diabetes
• Alcoholism
• Carpal tunnel tumor
• Old age

Symptoms of CTS may come and go initially and typically start gradually without a specific injury. As the condition progresses, symptoms may become more frequent. 

Early symptoms of carpal tunnel syndrome include:

• Nighttime numbness
• Tingling or pain in the thumb, index, and middle fingers
• Reduced fingertip sensation
• Difficulty with small tasks

Shaking your hands can sometimes relieve early symptoms. 

Nighttime symptoms are common and can wake you up from sleep as you might sleep with your wrists curled. Daytime symptoms arise when holding objects for long periods with bent wrists, like using a phone, driving, or reading.

Severe carpal tunnel syndrome symptoms include:

• Hand weakness
• Difficulty with delicate tasks
• Dropping objects
• Atrophy in thumb

Symptoms of carpal tunnel syndrome resemble other medical conditions; therefore, proper diagnosis is important. 

Early diagnosis and treatment are crucial to prevent prolonged harm and permanent damage. Our team will discuss your symptoms and medical history before the diagnosis process. The diagnosis of carpal tunnel syndrome includes:

A thorough examination of your hands, arms, shoulders, and neck can help rule out other conditions.

Routine tests and X-rays can reveal fractures, arthritis, or conditions like diabetes that could damage nerves.

Wrist tests can produce CTS symptoms. They include:  

• The Tinel test involves tapping or pressing the median nerve, creating a tingling or shock-like sensation. 
• The Phalen test checks for tingling or numbness when holding your hands together.

These tests confirm CTS diagnosis and include:

• Nerve conduction study measures impulse transmission speed.
• Electromyography evaluates the severity of median nerve damage in CTS. The test involves inserting a fine needle into a muscle to measure its electrical activity, providing insights into the extent of nerve impairment.

Imaging tests help in CTS diagnosis and other problems. This includes: 

• Ultrasound displays abnormal median nerve size.
• Magnetic resonance imaging (MRI) shows wrist anatomy but isn't particularly effective for diagnosing carpal tunnel syndrome.

Non-surgical treatment methods are employed for early diagnoses and milder cases, allowing continued daily activities. Non-surgical treatment options can include:

• Bracing or splinting: Wearing a brace or splint at night to maintain a neutral wrist position and reduce pressure on the nerve.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Prescription or over-the-counter medications like ibuprofen to alleviate pain and inflammation.
• Activity changes: Adjusting hand and wrist positions during prolonged activities to mitigate your symptoms.
• Steroid injection: Injecting corticosteroids into the carpal tunnel to offer relief. The effectiveness may vary depending on severity.
• Nerve gliding exercises: Recommended exercises to enhance the median nerve's movement within the carpal tunnel.

Surgery is recommended in severe cases or when non-surgical treatments prove ineffective. If symptoms persist after six months, surgery may be suggested to increase tunnel size and alleviate nerve and tendon pressure.

Carpal Tunnel Release 

The surgical procedure for carpal tunnel syndrome is known as carpal tunnel release. This procedure aims to increase the tunnel's size to decrease the pressure on the nerves and tendons that pass through the space. The procedure employs one of two surgical techniques: 

1. Open Carpal Tunnel Release
2. Endoscopic Carpal Tunnel Release

Outcomes for both surgical techniques are similar. At Kimball Health Services, our team will recommend the most suitable surgical plan for your condition.

At Kimball Health Services, our team provides personalized care and effective treatments for carpal tunnel syndrome. If you are experiencing pain or discomfort in your wrist and suspect carpal tunnel syndrome, walk into our facility anytime. 

In case of an emergency, call 911 or walk into our emergency department anytime. For appointments, call ahead or fill out our online form. We're here for you whenever you need us.