Understanding Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is one of the most common nerve disorders, affecting millions of people worldwide. It occurs when the median nerve, which runs from the forearm into the palm, becomes pressed or squeezed at the wrist. Common symptoms include pain, numbness, and tingling in the thumb, index, middle fingers, and the radial half of the ring finger. Early diagnosis and treatment are crucial for preventing permanent nerve damage.

Diagnosis of Carpal Tunnel Syndrome

Proper diagnosis of CTS is essential to tailor the right treatment plan. Several diagnostic methods are leveraged at RWJUH Hamilton, including:

• Physical Examination: This initial step involves examining the wrist, hand, and fingers to assess strength, sensation, and signs of nerve irritation or damage. Common tests include the Phalen maneuver, median nerve compression test, and evaluating thumb abduction weakness.
• Electrodiagnostic Studies: These studies, including nerve conduction and electromyography, confirm CTS diagnosis, gauge severity, and help rule out other conditions.
• Ultrasound: Used to measure the cross-sectional area of the median nerve, this noninvasive test can help diagnose CTS, particularly in atypical cases.
• X-rays and MRI: These imaging tests might be employed to exclude other potential causes of wrist pain, such as arthritis or fractures.

Treatment Options

Nonsurgical Treatments

• Splinting: Wearing a wrist splint, especially at night, can help alleviate pressure on the median nerve.
• Corticosteroid Injections: Local injections can provide significant relief and delay the need for surgery.
• Physical Therapy: Techniques such as therapeutic ultrasound, carpal bone mobilization, and nerve glide exercises can aid in managing symptoms.
• Medications: Although nonsteroidal anti-inflammatory drugs (NSAIDs) may not be very effective, they can offer short-term relief.

Surgical Treatments

Carpal Tunnel Release: This surgical procedure involves cutting the transverse carpal ligament to relieve pressure on the median nerve. It can be performed as open release surgery or endoscopically. Both methods are equally effective but endoscopy may allow for a quicker recovery.

Recovery and Management

Recovery from conservative treatments can start within two to six weeks, with maximum benefits often seen at three months. Surgical recovery usually takes one to two months. At RWJUH Hamilton, a multidisciplinary approach ensures comprehensive care, from diagnosis through rehabilitation.

Prevention

While preventing CTS can be difficult, particularly if it’s caused by unavoidable factors, certain strategies can reduce the risk. These include protecting wrists by limiting repetitive motions, ensuring proper ergonomics during activities, and taking regular breaks to stretch and shake out hands and wrists.