Symptoms

Usually the symptoms start gradually with numbness or tingling in your thumb, index and middle fingers that comes and goes and may be associated with discomfort in your wrist and hand. This sensation often occurs while holding a steering wheel, phone or commonly, waking patient from sleeping. The sensation may extend from your wrist up your arm. Many people "shake out" their hands to try to relieve their symptoms. As the disorder progresses, the numb feeling may become constant. 


Causes

As we mentioned the Carpal tunnel syndrome occurs as a result of compression of the median nerve. In general, anything that crowds irritate or compresses the median nerve in the carpal tunnel space swelling and inflammation resulting from rheumatoid arthritis or a wrist fracture can lead to carpal tunnel syndrome. Obesity and lower than normal thyroid gland function can also lead to Carpal Tunnel Syndrome. 


Tests and diagnosis 

History of symptoms and physical exam usually leads to diagnosis. Pressure on the median nerve at the wrist, produced by bending the wrist, tapping on the nerve or simply pressing on the nerve, can bring on the symptoms in many people; however sometime you may need other diagnostic test such as X-ray of the affected wrist to exclude other causes of wrist pain, such as arthritis or a fracture. Electromyography (EMG) measures the tiny electrical discharges produced in muscles and evaluates the electrical activity of your muscles when they contract and when they're at rest. This test can determine if muscle damage has occurred and also may be used to rule out other conditions. Nerve conduction study may be used to diagnose your condition and rule out other conditions; two electrodes are taped to your skin and small shock is passed through the median nerve to see if electrical impulses are slowed in the carpal tunnel. Based on the result, you may be required to see neurologist and hand surgeon.


Treatments and drugs 

Carpal tunnel syndrome should be treated as early as possible after you begin to experience symptoms.

Mild symptoms of carpal tunnel syndrome can be managed by taking more frequent breaks to rest their hands, avoiding activities that worsen symptoms such as sleeping on the hands to help ease the pain or numbness in your wrists and hands. We may consider additional treatment options such as nocturnal wrist splinting and medication which are effective on only mild to moderate cases for less than 10 months. High-intensity ultrasound can be used to raise the temperature of a targeted area of body tissue to reduce pain and promote healing. A course of ultrasound therapy over several weeks may help improve the symptoms of carpal tunnel syndrome. Nonsteroidal anti-inflammatory drugs may help relieve pain in the short term. Cortisone injection into the carpal tunnel can relieve the pain by reducing inflammation and swelling which relieves pressure on nerve, if other measures fail. 


Surgery

In cases of Carpal Tunnel Syndrome that symptoms are severe or persist after trying nonsurgical therapy, surgery may be the most appropriate option to relieve pressure on your median nerve by cutting the ligament pressing on the nerve.

Carpal Tunnel

Appointments:

(703) 492-6660
Greater Washington
Arthritis, Rheumatology and Osteoporosis Center

Carpal Tunnel Syndrome


Carpal tunnel syndrome is a condition that causes numbness, tingling, pain and eventually weakness of hand and arm and is caused by a pinched nerve in the Carpal tunnel which is is a narrow passageway located on the palm side of your wrist.

Early diagnosis and proper treatment usually can relieve the symptoms and restore wrist and hand function for most people who develop this syndrome.