Carpal Tunnel Syndrome (CTS) is one of the most common – and most commonly misunderstood – extremity problems in the United States today. Many people are under the impression that typing is the primary cause of CTS when in fact, most experts agree that typing is entirely unrelated to CTS. Instead, things like diabetes, low thyroid hormone levels, genetics, rheumatoid arthritis, obesity, and smoking have been more closely linked to CTS.
What is Carpal Tunnel Syndrome?
CTS is a condition that occurs when the flexor tendons – the nine tendons that bend your fingers and thumb – swell and put pressure on the median nerve. The median nerve passes through the carpal tunnel in your wrist and goes into the hand. The carpal tunnel is a narrow passageway in the wrist that’s made up of the carpal bones and a strong band of connective tissue called the transverse carpal ligament. The carpal tunnel is extremely rigid and doesn’t have much ability to stretch, so when the flexor tendons that pass through it swell, they place excess pressure on the median nerve, which leads to CTS.
What are the Symptoms of CTS?
The most common symptoms of CTS are numbness, pain, weakness, and tingling in the wrist, forearm, hands, and fingers that usually present at nighttime. You may also experience numbness or tingling during the day while doing normal activities like talking on the phone or driving, or you may find yourself unexpectedly dropping things on a regular basis.
How is CTS Diagnosed?
Early diagnosis is crucial for CTS. If left untreated, in most cases, CTS will continue to get worse over time and could lead to permanent deterioration of the muscles and nerves. If you are experiencing any symptoms of CTS, it’s essential that you seek medical attention as soon as possible. A CTS examination will start with a thorough evaluation of your medical history followed by a physical exam. There may also be some nerve conduction testing, which measures the signals traveling the nerves of your hand and arm. If your nerves aren’t effectively conducting a signal, that may indicate you have CTS. You may also need an x-ray to rule out other causes for your symptoms, including injury, fracture, and arthritis.
What are Some Carpal Tunnel Treatments?
Non-surgical carpal tunnel treatments – including rest, bracing or splinting, and steroid injections – will likely be explored before resorting to surgery. Wearing a brace or splint will prevent you from bending your wrist in ways that exacerbate your CTS symptoms and will keep your wrist in a neutral position, which reduces pressure on the median nerve. Steroid injections are a powerful anti-inflammatory that can help relieve your CTS symptoms.
If non-surgical treatments fail to provide you with relief, the next step in carpal tunnel treatments is surgery. Dr. Desai is one of the foremost hand surgeons in Virginia and is an expert at performing endoscopic surgery to relieve the symptoms of CTS. During this surgery, you’ll be placed under general or regional anesthesia, and the endoscope will enter through a limited incision. Then, the ligament that’s restricting the median nerve will be divided to relieve the pressure, and the incision will likely be closed using skin glue so that no stitches are necessary. You’ll be left with a soft bandage covering the incision that needs to be kept on for 48 hours. While you should wait a few weeks to resume activities like heavy lifting and playing instruments, you can resume normal, light activities like eating, dressing, and using the restroom immediately after surgery. You’ll be given a sheet of exercise to do for two weeks after surgery, and you may experience some pain, swelling, or stiffness. In rare cases, hand therapy is needed after surgery, but the majority of patients recover without any complications.
If you’re experiencing any symptoms of CTS, call Dr. Desai today to set up an appointment.