One of the most common and talked about hand problems today, carpal tunnel syndrome, affects an extremely wide and diverse group of individuals. Carpal tunnel syndrome develops as a result of increased pressure on the median nerve as it passes from the forearm to the hands supplying sensation to all of the digits except for the little finger. This increased pressure on the median nerve can develop for a number of reasons. Frequently, individuals who anatomically have a rather tight carpal tunnel begin with find themselves in jobs, sports, or hobbies that require repetitive flexion of the wrist or prolonged power gripping. Such activities increase the pressure in the carpal tunnel in the wrist and, thus, the pressure on median nerve. Pressure on this nerve leads to numbness in the hand and fingers and severe pain that often radiates proximally to the forearm and even to the shoulder. Patients from all walks of life can develop carpal tunnel syndrome. Symptoms can develop not only from heavy use of the hand but also from lighter repetitive use as is seen in an office worker using a computer keyboard many hours a day. Patients often complain of sleep disturbances, weakness or clumsiness of their hands and difficulty performing simple tasks such as driving or blow drying their hair.
Carpal tunnel syndrome can be diagnosed by a combination of patient history, clinical exam and, when necessary, diagnostic tests. Treatment of carpal tunnel syndrome in its earliest stages can begin with conservative nonoperative techniques involving hand therapy, splinting of the wrist, and modification of work activities. In some patients, limited steroid injections into the carpal tunnel can provide at least temporary relief from pain symptoms.
For patients with longer standing, more severe symptoms, surgery can often provide rapid, safe and predictable relief of symptoms of pain and numbness. Minor carpal tunnel release surgery involves a simple 12 to 15 minute procedure using a less than 2 cm incision at the base of the hand to release the band of tissue compressing the nerve. Recovery and return to work is usually quick and uneventful. Most patients recover completely from their pre-op symptoms of pain and numbness and resume a fuller, richer lifestyle.