OrthoVirginia Blog

Carpal Tunnel Syndrome Diagnosis and Treatment

Often, people with numbness and tingling in the hand may try to ignore their discomfort. All too soon, however, numbness and tingling may progress into swelling and pain, and work, family, and quality of life becomes negatively impacted. When the diagnosis is carpal tunnel, physicians at OrthoVirginia are poised to lend a helping hand.

What causes Carpal Tunnel Syndrome?

Carpal tunnel results from compression of the median nerve, one of the three major nerves that supply sensation and function to the hand. This nerve travels through a “tunnel” in the wrist, a narrow passageway comprised of the transverse carpal ligament and the carpal bones at the base of the hand, as well as some tendons connected to the fingers and thumb.

Some people are more predisposed to getting carpal tunnel syndrome than others. Women are three times more likely to experience carpal tunnel than men. Other risk factors or indicators, according to Alexander Croog, MD, orthopaedic surgeon at OrthoVirginia, are diabetes, rheumatoid arthritis or other inflammatory conditions, under-active thyroid or a previously broken wrist. Some studies have linked certain careers with carpal tunnel pain, such as those requiring constant typing or handling of vibrating tools, such as a jackhammer.

Diagnosing Carpal Tunnel Syndrome

Diagnosing carpal tunnel syndrome often takes several steps. Many patients can be diagnosed from their medical history and a physical exam. “This is more typical for someone who has progressive symptoms, such as numbness and tingling in the hand, or numbness in the thumb, index finger, middle finger, or ring finger for a series of months,” said Dr. Croog.

A nerve conduction study can confirm the diagnosis. During nerve conduction tests, a neurologist uses small, acupuncture sized needles to test how well a nerve conducts a signal.

After completing the tests, the patient must decide whether to wait or request a carpal tunnel release procedure.

Treatment Options

Treatment for Carpal Tunnel Syndrome includes both operative and non-operative approaches. The easiest place to start is with a metal wrist splint. Patients wear it while they sleep at night and for any activities during the day which usually bring about the numbness. If the symptoms persist despite wearing a wrist splint, some patients may benefit from a cortisone injection. The cortisone acts to decrease the inflammation and pressure around the nerve.

Some patients require surgery for carpal tunnel syndrome. Several types of surgery are available at OrthoVirginia. Dr. Croog performs a minimal-incision carpal tunnel release. For this technique, the incision, which is usually about three centimeters, is made on the palm, close to the wrist.

Surgeons advise patients to return to normal activity as soon as possible after carpal tunnel release surgery. “When the stitches come out, the patients have no limitations,” Dr. Croog said.