Is There Light At the End of Carpal Tunnel Syndrome? (video)

Treatments range from rest to physical therapy to surgery

Treatments range from rest to physical therapy to surgery

The symptoms of carpal tunnel syndrome are all too familiar to people who develop this very common and often-debilitating condition that affects the hand and wrist.

Symptoms may start this way: You wake up at night with painful tingling sensations in your fingers. Later as your condition worsens, your hand gets weaker, and you start dropping things.

Fortunately, there is light at the end of this tunnel of pain and sleepless nights.

In this video, San Diego Health host Susan Taylor and guest Lorenzo Pacelli, MD, an orthopedic surgeon at Scripps Clinic Torrey Pines and Scripps Clinic Carmel Valley, discuss treatments for carpal tunnel syndrome as well as causes, risk factors and symptoms.

What is carpal tunnel syndrome?

Carpal tunnel syndrome or CTS results from pressure on a nerve that passes through the wrist area on the palm side of the hand. It causes numbness and tingling in the thumb, index, middle finger, and sometimes half of the ring finger.

“The carpal tunnel is a small space in the center of the wrist. In this space is a nerve and all the little tendons that go to the fingers,” Dr. Pacelli explains. “Carpal tunnel happens when there is swelling in these tendons in a very tight space. When it gets to a certain point, the nerve gets compressed, and symptoms occur.“

Many things can cause that nerve to be compressed. Hand overuse, especially strenuous activities, can cause nerve compression. Repetitive tasks can cause this, including spending too much time typing on even gardening.

“We have patients that come in and have spent eight hours in the garden, cutting and shearing things. That can be really hard on your hands,” Dr. Pacelli says.

Swelling during pregnancy can cause carpal tunnel syndrome. Certain diseases can cause swelling in the flexor tendon, including diabetes and thyroid issues.

What are the symptoms of carpal tunnel syndrome?

Symptoms usually involve pain and numbness and tingling in the fingers.

“Many times, patients come in complaining of being unable to sleep at night, waking up in the middle of the night with their fingers and their hand going numb,” Dr. Pacelli says. “Most of the time it’s very debilitating because they can’t sleep. That’s the primary reason they come in.”

The hands get weaker as the condition progresses. “When that happens, you drop things. You drop cups. You drop bigger objects that you’re trying to pick up,” Dr. Pacelli adds.

What are treatments to relieve pain?

Non-surgical treatments range from resting and splinting to anti-inflammatory medications and physical therapy. Wearing a splint at night to sleep can help with numbness and tingling symptoms.

“Sometimes we’ll even do a cortisone injection to reduce the swelling around those tendons and help to relieve the pressure on the nerve,” Dr. Pacelli says.

If those approaches don’t work, surgery may be an option. “It’s a very effective way of getting rid of carpal tunnel syndrome,” he says.

What is carpal tunnel surgery?

Surgery involves taking pressure off the nerve by opening space for the carpal tunnel. “Surgery involves making a cut through this big thick ligament. Once you make that cut, it takes the pressure off the nerve,” Dr. Pacelli says.

Recovery is usually two to three weeks. The hand may be weak for up to a month, but the symptoms usually go away within the first week of surgery.

How to prevent carpal tunnel syndrome

To reduce the risk of developing carpal tunnel syndrome, avoid repetitive activities, especially strenuous activities. Also:

  • Take frequent breaks.
  • If at risk, wear protective braces.
  • Do finger stretching exercises. A physical therapist can teach you.

When to see your doctor?

If your fingers are going numb and tingly, waking you up at night, keeping you from doing things, then it’s time to see your physician. Don’t wait too long. If you ignore these symptoms for a prolonged period, it can cause permanent damage to the nerve and the use of your hands.

“It’s not something you want to ignore,” Dr. Pacelli says. “As soon as it starts waking you up at night, that can be the primary reason to come in.”

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