Purpose Of Carpal Tunnel Surgery
The median nerve, which starts at the shoulder and extends down to the tips of the fingers, is one of the major nerves of the upper extremities. This nerve not only directs the contractions of muscles in the forearm and hand but provides sensation to the hands and fingers.
When the median nerve is compressed in the carpal tunnela narrow passageway from the wrist to the hand that’s made of tendons, ligaments, and bonessymptoms of carpal tunnel syndrome can develop and, over time, become chronic.
Carpal tunnel surgery is generally indicated when you fail to respond to conservative therapies after more than six months.
From a physiological standpoint, surgery should be pursued if carpal tunnel syndrome manifests with the following features:
- Severe chronic pain
- Inability to place the thumb in a perpendicular position
- Loss of finger dexterity
- Loss of protective sensation in the fingers and hand
- Loss of two-point discrimination, the ability to discern two separate objects touching the skin at the same time
Carpal Tunnel Syndrome Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Physical Therapy To Determine The Root Of Pain Post
Post-operatively, some carpal tunnel release patients could still feel pain and numbness in their hands three months following the operation. While it may be a fairly common side effect of the operation, the root of the problem may actually be determined through physical therapy.
Working together with our orthopedic surgeon, our physical therapist will help in determining if theres a surgical injury, neurogenic pain, and other associated conditions. Working with a therapist may also help the patient manage these uncomfortable moments during the recovery period.
This process is more than just a physical examination as it can also be for patient education. By doing a thorough exam, such as measuring the strength of the fingers and hands, our physical therapist can advise the patient on how to do correct movements and exercises that will make them feel more comfortable.
How To Relieve Carpal Tunnel Pain
For most people, it doesn’t matter where carpal tunnel pain is as long as they can treat it. But it may surprise you that treating the pain symptoms is only slightly helpful. But treating thecauseof the pain is far more effective and lasting. In other words:
If you treatonly the painit will come back. But if you treat thecause of the painit will eliminate symptoms forever.;
Therefore, where carpal tunnelpainis your main symptom, there are 2 approaches to treating it:
- temporary pain treatmentswhich just treat pain for the time being
- permanent pain treatmentswhich treat & eliminate the source of the pain
I highly recommendyou use thepermanent pain treatmentsfor obvious reasons. I list the temporary ones below because you’ve probably tried them – with no long-term effects.
Also Check: How To Know If Carpal Tunnel Is Infected
Who Is At Risk For Carpal Tunnel Syndrome
People at risk for carpal tunnel syndrome are those who do activities or jobs that involve repetitive finger use. Motions that can place people at risk of developing carpal tunnel syndrome include:
- High-force .
- Extreme wrist motions.
Many other factors can also contribute to the development of carpal tunnel syndrome. These factors can include:
- Heredity .
- Amyloid deposits .
Carpal tunnel syndrome is also more common in women than in men.
What Are The Potential Causes Of Cts
The;National Institute of Neurological Disorders and Stroke reports that CTS may be caused by wrist injuries, overactive pituitary gland, hypothyroidism,;and arthritis. They also claim that repeated flexing or bending of the wrist, pregnancy,;and menopause could contribute to CTS.
The;Mayo Clinic;has also claimed that the usage of vibrating tools or other occupations that require prolonged and repetitive flexing of the wrist may contribute to the development of CTS.
These claims concerning occupation and CTS make sense. There are many occupations that do require the same wrist and finger motion on a day-to-day basis. A number of the same people who occupy these positions have been known to experience CTS.
However, a positive association between CTS and specific occupations is anything but certain.
In reading a number of pamphlets and studies concerning CTS there seems to be an assumed belief about occupations that involve repetitive wrist and finger movements must contribute in some way to the development of CTS. Yet, data supporting this notion has proven to be elusive.
Don’t Miss: Does Toothache Cause Neck Pain
There Is A Bright Ray Of Hope For People Suffering From Cts
CTS sufferers will tell you that the syndrome can prove excruciating, if only due to its chronic nature. The fact that it often returns even after invasive procedures like steroid injections or risky surgery and long rehabilitation periods can be especially frustrating. The fact that the numb sensations in the hand can return is why it is so important to chose an all natural therapy without complications, risks or downtime. There is a bright ray of hope for people suffering from CTS.
The Carpal Solution;;is a unique, innovative, and clinically tested soft tissue training brace, which is sometimes referred to as a wrist brace, but more often as an Orthosis Device by the American Medical Association and Health Insurance Companies.
This remarkable all natural therapy has demonstrated remarkable success with a diverse range of chronic carpal tunnel syndrome cases. Over 97% of CTS sufferers find they can control their condition with this all natural therapy. If you are in the 3% for whom it is not effective, then you can always resort to more invasive, expensive and risky procedures, like surgery, after trying the all natural and clinically proven 6 week Carpal Solution Protocol.
It is also so convenient.
You simply treat yourself at night during sleep in the privacy and convenience of your own home. You are going to like the way you feel in the morning after a sound nights sleep awaking without numb tingling hands.
Research And Possible Risk Factors
Researchers have found that a previous wrist fracture and the use of insulin, metformin, and sulphonylureas are associated with a higher chance of CTS. Smoking, hormone replacement therapy , the combined oral contraceptive pill, and oral corticosteroids did not appear to be not linked to a higher risk of CTS.
One study has suggested that obesity, combined with a square-shaped wrist shape, may increase the likelihood of CTS developing. However, the team concluded that obesity was probably not the cause, because when participants with obesity lost weight, they continued to have CTS.
The same team concluded in other research that the age of women at the menopause might be a factor, and that pregnancy-related hormones may increase the risk of CTS in women at the time of the menopause.
Apart from work-related factors, the main risk for CTS is inflammatory arthritis, but hypothyroidism and diabetes also appear to increase the chance of developing it, according to research published in the Journal of General Internal Medicine.
The National Institute of Neurological Disorders and Stroke says that CTS is three times more likely to occur among people working in assembly operations than in data-entry personnel.
The Canadian Centre for Occupational Health and Safety list the following occupations as risk factors for CTS:
According to the National Library of Medicine, there is
Don’t Miss: Does Carpal Tunnel Cause Numbness
Diagnosis Of Carpal Tunnel Syndrome
Your GP will ask you about your symptoms and your medical history. Theyll want to know when you get symptoms, what triggers them, and how theyre affecting your daily life. Theyll carefully examine both your hands, looking for signs such as swelling or muscle wasting. Theyll also check the feelings in your fingers and thumb. They may carry out some brief tests to check your symptoms. These may include:
- asking you to bend your wrist with your palm towards your forearm
- tapping or pressing over your median nerve on the inside of your wrist
- pressing on the ligament over your carpal tunnel in your wrist
Your GP may be able to diagnose carpal tunnel syndrome just by examining you and asking about your symptoms. But sometimes they may ask you to have some further tests. These may include the following.
- Nerve conduction test this can show how bad any damage to your median nerve is.
- Ultrasound this allows your doctor to look inside your wrist, and can help to show if theres any underlying cause.
Some Common Symptoms Of Hand Numbness Or Tingling Sensations In The Hands And Fingers Reported By Cts Suffers When Visiting Our Doctors:
- Numbness in Palm of Hand
- Tingling Hands or Tingling Fingers
- Routine Dropping of Fork at Dinner
- Dropping Coffee or Drinking Cup
- Loss of Grip Strength in Palm
- No Accuracy with instruments or tools
- Inability to button button
- Loss of Feeling in Thumb
- Loss of Sensation in Middle Finger
- Loss of Feeling or Numbness in digits
- Numbness in Index Finger of hand
Read Also: How Do You Tell If Your Wrist Is Broken
Acupressure To Manage Carpal Tunnel Without Surgery
One such method is acupressure.;; In this method, the pressure is applied with the fingers on particular pressure points on the body to bring about pain relief. At the same time, improve circulation and enhance the innate ability of the body to heal.
You can do this yourself at home if you know the points.; One such point is at the crease of the elbow on the outer side of the tendon when you make a fist keeping the arm straight.
Apply moderate pressure with the index finger only on this point, for 2-3 minutes at a time.; Done regularly, this will ease the symptoms considerably.
Dont Miss: How To Relieve Knee Pain
Do I Have Carpal Tunnel Or Something Else
Carpal tunnel syndrome is a common term that we hear from family and friends when we complain of numbness or pain in the wrist. Its the one condition that seems the most likely cause because its quite well known. However, just because carpal tunnel syndrome is well-known does not mean it is the only condition that causes wrist pain and numbness.
It is important to understand the symptoms of other common conditions that relate to the hand and wrist, as well as carpal tunnel syndrome, to rule out other possibilities.
In this article, we will cover common conditions that cause numbing, tingling, pain, or numbness in the fingers and wrists as well as what you should do if you believe you have one of these conditions.
Carpal Tunnel Syndrome
Carpal tunnel syndrome happens when pressure is applied to your median nerve by the carpal bones. When swelling happens in your wrist, the carpal tunnel constricts the median nerve causing symptoms to appear. These symptoms could be radiating pain from the forearm to the shoulder, numbness, burning, or tingling starting at the thumb, pinky, or felt within the forearm.;
The symptoms of carpal tunnel syndrome typically start slow and are felt mostly at night. This is due to sleeping positions that cause restriction within the wrists. How to tell is if you feel the need to shake your wrist to regain feeling. As the condition worsens, you will begin to feel symptoms during the day while driving, typing, or talking on the phone.
Causes & Symptoms Of Carpal Tunnel
A narrow passageway on your handle’s side is the carpal tunnel composed of bones and ligaments. This passageway passes alongside the tendons to your fingers and the thumb through the middle nerve that controls sensation and motion in your thumb or first three fingers. The effect of engulfment, tingling, weakness, or pain in the hand when punched and compressed are called carpal tunnel syndrome. It is important to go for a carpal tunnel surgery for both hands If you face any of these syndromes.
If You Have A Combination Of These Specific Symptoms It Is Highly Probable That You Are Suffering From Carpal Tunnel Syndrome
These symptoms of numbness, missing feeling sensation and loss of fine motor skills can be extremely frustrating. We do not realize how much we depend on the feeling in our hands until it is gone. The miracle of the human body escapes us when everything is working well. When the muscles, ligaments and soft tissue in your hands and forearms experience trauma due to accumulating and sometimes subtle repetitive stress patterns, they get inflamed and thus put pressure on the nerve running through the carpal tunnel at the base of the hand where it meets the wrist.
Don’t Miss: What Dr To See For Wrist Pain
Could Your Job Be To Blame
It’s a common belief that frequent typing can lead to carpal tunnel syndrome. But it’s actually three times more common among assembly line workers than it is among data-entry personnel — and frequent use of vibrating hand tools increases the risk. In contrast, one study found that even heavy computer use — up to seven hours a day — did not make people more likely to develop carpal tunnel syndrome.Â;
Conditions With Symptoms Similar To Carpal Tunnel Syndrome
Other conditions, including different types of nerve compression, can look like carpal tunnel syndrome. Some of these are:
- Arthritis.Arthritis of the wrist can cause many of the same symptoms. One key difference is that arthritis may cause visible swelling and redness.
- Cubital tunnel syndrome. Also called ulnar tunnel syndrome, this condition is due to compression, or squeezing, of the ulnar nerve in the elbow. Symptoms are more likely to affect the pinkie, ring finger, and inside of the hand.
- Pronator syndrome.Pronator syndrome is a condition in which the median nerve in the arm is compressed. Pain is typically felt in the arm but can extend to the palm, making it difficult to make the OK sign.
- Radial tunnel syndrome.Radial tunnel syndrome is due to compression of the radial nerve, which runs from the neck through the arm. It rarely causes the numbness or tingling of carpal tunnel syndrome. Pain is more likely to occur in the forearm or back of the hand.
- Tendonitis.Tendonitis of the wrist is due to inflammation of the tendons. Unlike carpal tunnel syndrome, tendonitis may cause swelling, and the pain tends to improve with rest.
Don’t Miss: Do Chiropractors Help Shoulder Pain
What Causes Carpal Tunnel Syndrome
CTS happens when the carpal tunnel inside your wrist swells and squeezes 1 of your nerves .
You’re more at risk if you:
- are overweight
- are pregnant
- do work or hobbies that mean you repeatedly bend your wrist or grip hard, such as using vibrating tools
- have another illness, such as arthritis or diabetes
- have a parent, brother or sister with CTS
- have previously injured your wrist
Page last reviewed: 16 February 2021 Next review due: 16 February 2024
When Its Time To See The Doctor
If these home treatments dont ease your pain in one or two weeks, it might be time to see an orthopaedic physician, who specializes in treatment of bones, joints and muscles.
Your doctor may recommend surgery if theres severe damage to your median nerve or to prevent permanent sensory or functional loss, Dr. Seitz says.
The surgery involves cutting the band of tissue in the wrist that crosses the median nerve to lessen the pressure.
Over time, surgery may be the best route to permanent relief, Dr. Seitz says.
Recommended Reading: Can Coffee Cause Stomach Pain
Treatment Of Mild And Moderate Cts
The treatment of CTS is based upon the severity of CTS that each patient possesses. Most patients will most likely have a mild or moderate form. Both of which tolerate conservative forms of treatment.
Recommended management of mild and moderate CTS, per the;NINDS, is 24-hour splinting, lifestyle and activity accommodations, medication and stretching.
They also report that some have experienced relief of symptoms via acupuncture and chiropractic adjustments.
An example of a chiropractic self-release exercise can be viewed below.
According to;Elliott, massage therapy coupled with trigger-point release has revealed itself to be a legitimate alternative therapy for CTS. Patients who attempted this experienced a notable improvement in their symptoms after 2 weeks of treatment.
Physical therapy is also recommended. Three recommended exercises are detailed in the following video. These three exercises are nerve gliding, chest stretch,;and rib mobilization.
Why Surgery Should Be A Last Resort
Even without complications, recovery from carpal tunnel surgery can take anywhere from a few days to a few months, and can often require physical therapy. And in those 1% of patients, the instances of infection can bring disastrous consequences. Not only do you face the risk of losing your limb or your life, at minimum youll experience extended recovery time and a potentially extensive hospital stay, where doctors will typically prescribe powerful antibiotics administered via an I.V. In almost any situation, surgery is considered a last resort, particularly because of the risk of infection.
If at all possible, treating CTS non-surgically is the best way to avoid infection and further complications. Thankfully, there are many ways to treat this issue; if you can provide relief for your median nerve, youll soon experience a lapse in symptoms. But dont delay if you ignore the pain, it could become exponentially worse.
Read Also: Can A Tooth Infection Cause Neck Pain