Carpal tunnel syndrome: It’s all in the wrist

Understanding Carpal Tunnel Syndrome

Your wrist is a small part of your body, but it can be a big pain if you have carpal tunnel syndrome. Carpal tunnel is a condition that leads to pain, numbness and tingling in the hand and forearm. Many describe carpal tunnel syndrome as a “shocking” feeling in the hands or a feeling that the hands and fingers have “fell asleep”. The pain often feels like it is coming from inside of your hand and wrist, rather than from the skin-level.   

Carpal tunnel is extremely common, with estimates of 3 out of every 1,000 people diagnosed with the condition every year.  

What is carpal tunnel syndrome? 

The carpal tunnel is a passage for nerves and tendons that runs through the wrist. The main nerve in the tunnel is the median nerve, which starts in the neck and travels through your arms and down to your fingers. When this nerve is squeezed or compressed – through swelling, repetitive motion, or injury – the pressure on the nerve causes pain, tingling, or numbness in your fingers and hands.  

Usually, carpal tunnel is the result of a combination of risk factors, which include: 

• Heredity. The carpal tunnel may be smaller in some people, a trait that is passed down through genetics. This anatomical difference can increase the likelihood of the median nerve being compressed. Additionally, rheumatoid arthritis and osteoarthritis can indirectly cause carpal tunnel syndrome.  
• Certain health conditions. Conditions like rheumatoid arthritis, gout, hypothyroidism, diabetes, obesity and amyloidosis can increase your risks. 
• Repetitive hand motion and hand/wrist position. Some evidence suggests that repeated hand and wrist motions and doing activities involving flexion and extension of the wrist for an extended period of time can aggravate the tendons in the wrist, causing swelling to the nerve.  
• Pregnancy. Pregnancy is a common cause of carpal tunnel. Hormonal changes that lead to fluid retention during and after pregnancy can cause carpal tunnel syndrome. Carpal tunnel during pregnancy can be acute but often goes away in postpartum.  
• Gender. Carpal tunnel is far more common in women than men. Additionally, a woman’s age increases the risk factor for carpal tunnel, with the condition being more common with women 45-55 years old who are entering menopause.  

Signs of carpal tunnel can be tricky to pick up on because they come on gradually. They might include: 

• Numbing and tingling, especially in the thumb, index, and middle fingers. While pain is associated with CTS, numbness is the key symptom.  
• Numbness at night that tends to radiate upwards towards the elbow and shoulders. 
• Numbness accompanied by elbow and shoulder pain are additional indications of carpal tunnel.  
• Dropping objects due to hand weakness or numbness. 
• Everyday activities make the pain and numbness worse. These activities include using a steering wheel, using a keyboard, applying makeup or cooking.  

Carpal tunnel treatment 

If you notice any symptoms, it's time to talk to your health care provider. During an evaluation, your hands and wrists will be examined and tested. Many times, this physical examination is all that's needed for a diagnosis. 

Sometimes lab tests such as an x-ray or ultrasound may be needed. Your provider might refer you to an orthopedic doctor who specializes in bones, joints, muscles and nerves. 

At home treatments to treat CTS include: 

• Wearing a wrist brace, especially when sleeping.  
• Taking anti-inflammatory medication like OTC medication like ibuprofen. 
• Adjusting wrist movements to promote ergonomics. 
• Exercising/stretching the hands and wrist can ease symptoms.  

If home remedies do not offer long-term relief, physicians can provide a solution. Prescribed medication and cortisone injections from a doctor may provide solutions for those with CTS.  

In some chronic cases, an orthopedic surgeon can provide surgical treatment. The goal of surgery is to divide the carpal ligaments to create a roof that will stop the median nerve from being compressed and causing pain. Surgery is often minimally invasive, with a small incision in the wrist, and patients often have immediate use of their hand following surgery. 

We’re here to help 

There’s no need to live with carpal tunnel pain. Diagnosis and treatment are available. Our specialized orthopedic team is here to provide relief for you.  

🩺 Need to see someone? Make an appointment with one of our providers at lcmh.com/Find-A-Doc. If you require surgery for treatment of carpal tunnel syndrome, Lake Charles Memorial is home to a specialized orthopedic hand surgeon – Dr. Barry Henry.

Click here to learn more about our orthopedic care team. 

📚 Want to dig deeper? Visit the American Academy of Orthopaedic Surgeons or the American Medical Association.  

Resources:  

American Academy of Orthopaedic Surgeons 

National Institute of Arthritis and Musculoskeletal and Skin Diseases 

Cleveland Clinic 

American Medical Association 

National Institutes of Health