| A Patient's Guide
to Carpal Tunnel Syndrome Treatment |
| Carpal Tunnel Syndrome (CTS), while becoming increasingly
well known, is often not well understood. This section of our
website was desgined to help you learn more about this condition
and how it is treated. If you're feeling discomfort and think
you may have carpal tunnel syndrome, be sure to see your doctor
at once. Treatments for carpal tunnel syndrome are highly successful,
but early diagnosis is very important to achieve the best results
and avoid permanent damage. |
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| What is Carpal Tunnel
Syndrome? |
| In the center of the wrist, there
is a space called the carpal tunnel where a major nerve (the
median nerve) and nine tendons pass from the forearm into the
hand. A very strong ligament forms a roof over the tunnel. When
there is swelling in the carpal tunnel, pressure is put on the
median nerve, which supplies most of the fingers and thumb with
feeling and movement. When pressure becomes great enough to
compress the nerve, Carpal Tunnel Syndrome may occur. It is
a condition which afflicts over 2.5 million Americans every
year. The transverse carpal ligament is the roof over the bony
carpal tunnel which houses nine tendons and the median nerve.
When there is swelling within the tunnel, pressure is put on
the nerve. Pain, numbness and tingling may result. |
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| What are
the Most Common Symptoms of Carpal Tunnel Syndrome? |
- Numbness
- Tingling
- Burning
- Pain in the fingers, hand and wrist
that may extend up to the shoulder
|
|
The darker area
shown represents the area most affected by symptoms of Carpal
Tunnel Syndrome. |
| These symptoms may occur alone or
in combination in either or both hands. Numbness or tingling
is felt most often in the thumb, index, middle and ring fingers.
The symptoms frequently occur at night. They may also be noticeable
while performing daily activities like reading, driving, and
doing household chores. A weakening of the grip may become apparent,
along with a tendency to drop objects. |
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| What Causes
Carpal Tunnel Syndrome? |
| Swelling of the lining of a tendon
commonly causes pressure build-up in the carpal tunnel. Repetitive
use of the hands can cause this type of swelling. Activities
that involve grasping, squeezing, or clipping may also be associated
with the problem. Fluid retention during pregnancy can sometimes
cause swelling in the tunnel but symptoms typically go away
after delivery. Some medical conditions such as rheumatoid arthritis
have been found to be an actual cause of CTS while other conditions
like hypothyroidism and diabetes may cause only symptoms of
CTS. Arthritis and bone dislocations or fractures that narrow
the tunnel are less common causes. |
| |
| What are
the Treatment Options? |
| Conservative
Treatment (without surgery): Reducing activities that
cause continuous exertion or repetitive use of your hands, or
keeping the wrist in a neutral position may help reduce the
swelling within the carpal tunnel and relieve pressure from
the nerve area. Wearing wrist splints at night may relieve the
symptoms and accommodate a better night's rest. Anti-inflammatory
medication taken orally or injected into the carpal tunnel may
help reduce the swelling and relieve symptoms. |
| Surgical
Treatments: When symptoms are severe or do not improve
with non-surgical treatments, surgery may be elected to enlarge
the carpal tunnel by cutting (releasing) the ligament to allow
more room for the median nerve. Traditional Open Surgery In
this procedure, an incision made through layers of skin, fat,
fascia, and muscle, to identify and divide the transverse carpal
ligament. During traditional open carpal tunnel surgery, the
ligament is exposed through the palm and then cut by the surgeon.
|
| |
| Endoscopic
Surgery |
| A new endoscopic procedure is now
available as an alternative to traditional open carpal tunnel
surgery. The procedure is performed using a device called the
MicroAire Carpal Tunnel Release System. It allows the release
of the carpal ligament through a small incision at the base
of the wrist. A small endoscope and camera project an "inside
view" of the carpal tunnel onto a video monitor. The surgeon
watches the screen and is able to precisely cut the ligament
with a blade, simply by pulling a trigger. During small-incision
endoscopic carpal tunnel surgery, the ligament is released without
having to cut through the skin and muscles of the palm. Both
open and endoscopic carpal tunnel surgery have the same goal-to
ease pressure on the median nerve by dividing the ligament and
enlarging the carpal tunnel. |
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| What are
the Benefits of Endoscopic Surgery vs. Traditional Open Surgery? |
| "Open" carpal tunnel release has
been performed for many years and has proven to be very effective
in the treatment of CTS. The MicroAire endoscopic method, has
been performed successfully in thousands of cases and is also
effective in treating CTS. The primary benefit of endoscopic
surgery vs. open surgery is a significantly shortened recovery
period. While individual results vary, most patients return
to normal daily activities within days after endoscopic surgery
and return to work earlier than those who undergo the open method.
Recovery of hand strength following open surgery can take weeks
or even months while the palm heals. There is also less pain
and scarring with the MicroAire endoscopic procedure. Only a
very small scar, concealed in a wrist crease, remains after
healing. |
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| What Can
I Expect After Surgery? |
| With either open or endoscopic surgery,
the incision will be sutured. Your wrist and hand will be dressed,
and gentle hand exercises will begin soon after surgery. The
time it takes before you can resume normal activities and return
to work will vary with each individual. This is a decision that
should be made in consultation with your doctor. |
| |
| Discuss
the Options With Your Doctor |
| If you need carpal tunnel surgery,
your doctor will help you make an informed decision by explaining
your surgical options and the risks associated with both the
open and endoscopic procedures. If you choose the endoscopic
procedure, your doctor will also explain that there is a very
small chance the procedure would have to be converted to the
open method. Carpal tunnel release has been proven to be a highly
successful surgery with excellent results for most patients.
Your doctor will be happy to answer any questions you may have
about CTS and its treatment. |
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