The Carpal Tunnel is located in the wrist. The bottom and sides of the tunnel are formed by the wrist (carpal) bones. The transverse carpal ligament is a strong band of connective tissue that forms the top of the tunnel. The carpal tunnel protects a major nerve, as well as the tendons that bend the fingers and thumb.
Carpal Tunnel Syndrome is caused by the compression of the median nerve that travels through the carpal tunnel. People with this condition may experience numbness, pain, or tingling in the hand, usually in the thumb, index, and long fingers. Symptoms may come and go or be constantly present. Activities using the hand may become difficult, such as buttoning a shirt. If the condition continues to worsen, strength may decrease in the hand.
Some causes and factors of Carpal Tunnel Syndrome include heredity, age, and medical conditions such as rheumatoid arthritis and diabetes.
History and physical exam by a qualified musculoskeletal expert is the first step. Nerve testing may be ordered. In addition, a doctor will examine your ability to perform certain hand physical tasks.
Treatments for Carpal Tunnel Syndrome include non-surgical and surgical treatment. If untreated, the condition often worsens.
Splints or braces may be worn to relieve the condition. Medications, including anti-inflammatory drugs such as ibuprofen, may be recommended. Changes in certain activities may be suggested to avoid hand positions that aggravate symptoms. Steroid injections, such as cortisone, may also help to provide relief.
During surgery the ligament that forms the top of the tunnel is cut. Once it heals there will be more room for the nerve and tendons. Using an Endoscopic method, surgeons make a smaller incision and use a small camera to cut the ligament from the inside of the carpal tunnel.
Patients can resume light activities soon after surgery. Most patients’ symptoms improve after surgery but recovery may be gradual. Some patients may benefit from hand therapy to help improve function.