The same principle can happen with a tunnel in the human wrist, the carpal tunnel. The carpal tunnel is a narrow, fibrous passage in the wrist that protects the median nerve. This is the nerve responsible for movement and sensation in the hand and thumb, index and middle fingers. It can become congested, leading to tingling and numbness in the fingers — carpal tunnel syndrome.
What causes carpal tunnel syndrome?
Anything that decreases the amount of space in the carpal tunnel, increases the amount of tissue in the tunnel, or increases the sensitivity of the median nerve can lead carpal tunnel syndrome. This causes the carpal tunnel to squeeze and compress the median nerve. This is known as nerve impingement or entrapment and can lead to numbness, tingling, pain, and weakness in the affected fingers and thumb of the hand.
Carpal tunnel syndrome often shows itself in people whose jobs require repetitive use of their hands. For some unknown reason, it affects women more than men. The condition usually begins as an ache in the wrist that may extend down to the forearm or up to the hand. As carpal tunnel syndrome worsens, the patient may experience tingling or numbness in the fingers or pain radiating through the entire arm. At this point, there may also be weakness in the hand and difficulty in grasping small objects. Most people find the condition worse when first awakening in the morning and when using the fingers directly.
How we treat carpal tunnel syndrome
At The Orthopaedic Center, we have two goals for your carpal tunnel syndrome treatment: to allow you to return to your normal function and activities, and to prevent nerve damage and the corresponding loss of muscle strength in your fingers and hands. Our team begins with conservative methods to treat carpal tunnel syndrome:
- Resting the hands
- Utilizing cold packs to reduce inflammation through the carpal tunnel
- Anti-inflammatory drugs
- Physical therapy
- Corticosteroid injections
If these methods do not stop the pain and tingling in the fingers, we may opt to surgically relieve the pressure on the median nerve.
Carpal tunnel release
This procedure is called carpal tunnel release. The goal is to relieve pressure on the median nerve and reduce symptoms of carpal tunnel syndrome. The procedure can restore muscle strength and dexterity. At The Orthopaedic Center, we only consider surgery if your symptoms haven’t improved after several weeks to months of nonsurgical treatment or if you’re showing signs of nerve damage and decreased strength in the fingers and/or thumb.
We perform the procedure in two ways: endoscopically or through an open procedure. Which method we opt to perform depends on the individual situation of each patient.
Open carpal tunnel release involves a two-inch incision in the middle of the palm. This provides the surgeon a better view of the treated area and involves less risk of accidentally damaging nerves in the area.
Endoscopic carpal tunnel release involves only two tiny incisions and makes for less post-operative pain and a faster return to work. There may be a slightly higher chance of needing another surgery down the road.