Carpal Tunnel Syndrome

Carpal tunnel Syndrome is a common condition, with more than 3 million cases in the United States per year. While it is not a life-threatening condition, it can still get in the way of daily life and cause disruptions for people who have it. Zakary Knutson, MD, an orthopedic surgeon with Ortho Central, shares his insights into the condition including symptoms, treatment and how to navigate the condition.

What are the symptoms of carpal tunnel syndrome?

Carpal tunnel syndrome comes with several symptoms, all of which stem from a nerve underneath the wrist. It usually occurs in people who perform a significant amount of repetitive motions.

“Carpal tunnel syndrome is a result of a pinched nerve, the median nerve specifically. Right where your wrist begins to turn into your hand, you have a ligament called the transverse carpal ligament and the median nerve runs right underneath it like a bridge. The tissues around this nerve get inflamed or the ligament itself gets thick, which is what causes the symptoms,” Dr. Knutson said. “Those symptoms are usually numbness and tingling in the early phase, involving the thumb, index, middle finger and half of the ring finger. The pinky finger is usually left alone, but not always and when it progresses, the numbness and tingling can turn into weakness.”

People with carpal tunnel syndrome will often report dropping things; they notice that their thumb muscles begin to shrink as well. This happens when the nerve has been pinched for so long that it is now showing signs of permanent loss of function.

How do I treat my carpal tunnel syndrome?

Treatment for carpal tunnel Syndrome can vary from patient to patient. This can depend on how long the condition has been left untreated or how severe it is, among other factors.

“Like most things in orthopedics, we try to start conservatively. The conservative treatment includes stinting or steroid injections around the carpal tunnel to decrease the inflammation causing the nerve to be pinched,” Dr. Knutson said.

Other conservative treatments include:

• Activity modification
• Anti inflammatories
• Keeping hands warm

Sometimes these conservative treatments are able to fix the issue. If these don’t work, then the next step is to begin discussing surgery.

“Surgery is going to be done to release the transverse carpal ligament and to give the nerve room to breathe essentially,” Dr. Knutson said. “I usually recommend surgery once we begin to see signs of muscle wasting or permanent damage beginning to occur. At that point, we want to stop it from getting worse rather than alleviating symptoms. It will usually take months to years to get to this point and it comes from people avoiding treatment and hoping that it will just go away.”

How does carpal tunnel syndrome differ from arthritis?

There is a common misconception that carpal tunnel syndrome and arthritis are related, however there is often no correlation between the two.

“Carpal tunnel Syndrome is a nerve disease and arthritis is loss of cushion between the bones in the  wrist or hand. It is essentially like the tread on your tires wearing out, but instead it’s in between the bones. There’s no cushion, bones hurt and that’s where the pain comes from,” Dr. Knutson said. “There is not traditionally numbness and tingling associated with arthritis because it is separate from the nerve disease like Carpal Tunnel Syndrome.”

Exercises for carpal tunnel syndrome

Exercises for carpal tunnel syndrome are often not a long-term solution by themselves. Some patients do report improvements when pairing stretches and exercises with other forms of treatment, but ultimately, if the carpal tunnel has progressed far enough and has become severe, it is likely that the patient will need surgery to get relief. There are cases where exercises and stretches can help a patient recover after they have undergone surgery. Patients should consult their medical provider for guidance.

If you or someone you know is seeking treatment for carpal tunnel syndrome, the providers at Ortho Central are ready to help. Just call 405-360-6764.