A patient experiences numbness or tingling in the hands at night, a sharp pain that goes up into his or her arm up to his or her shoulder, difficulty in grasping objects without dropping them-these are warning signs for Carpal Tunnel Syndrome (CTS).
The carpal tunnel is comprised of bones, tendons and ligaments that surround the median nerve, which travels to the arm, wrist, hand and fingers. Carpal tunnel syndrome most often occurs when tendons in the wrist are inflamed after being aggravated by repetitive movements such as working at a computer. Inflamed tendons are swollen and crowd or pinch the median nerve, so that the carpal tunnel itself is not narrowed. This may cause progressive narrowing of the carpal tunnel, pinching nerves to the fingers and to the muscles at the base of the thumb. Symptoms of carpal tunnel syndrome can include hand and wrist pain, thumb and finger numbness or an electric-like shock feeling through the wrist and hand.
There are a number of causes associated with carpal tunnel syndrome. Any repetitive motions that cause significant swelling, thickening or irritation of the synovial membranes around the tendons in the carpal tunnel of the hand can result in pressure on the median nerve. Some causes include: repetitive and forceful grasping with the hands, consistent bending of the wrist, broken or dislocated bones in the wrist, arthritis, thyroid gland imbalance, diabetes and hormonal changes associated with pregnancy. However, in some cases, no cause is found.
Carpal tunnel syndrome occurs in both men and women. Pianists, concert violinists, assembly line workers, hairdressers, artists and sculptors, as well as pregnant women, can all suffer from carpal tunnel syndrome.
An estimated 260,000 carpal tunnel surgeries are performed each year, according to the Centers for Disease Control and Prevention. Forty-seven percent of these are considered to be work related. In addition, data from the National Center for Health Statistics indicates that 849,000 new visits were made to physicians in office-based practice in one year due to carpal tunnel syndrome.
Initial non-invasive treatment for carpal tunnel syndrome includes rest or use of a wrist splint during sleep. If patients experience severe pain that cannot be treated through rest, rehabilitation or non-surgical treatment, a relatively simple operative procedure, "carpal tunnel surgery," can be performed by a surgeon.
In this procedure, the volar carpal ligament is cut away from the course of the median nerve, thereby relieving the pressure on that nerve.
Factors leading to surgery include the presence of persistent neurological symptoms and lack of response to conservative treatment. Reoccurrence of symptoms after surgery for carpal tunnel syndrome is rare and occurs in less than 5 percent of patients.
The goal of this surgery is to relieve pressure placed on the median nerve in the carpal tunnel. The results of surgery are usually exceptional, with most patients receiving nearly full relief of their symptoms.