How Is A Diagnosis Made
Shooting pain in the hand signals carpal tunnel syndrome. An accurate diagnosis rules out other joint or muscle problems that can mimic this syndrome. Your doctor will check the feeling, strength, and appearance of your neck, shoulders, arms, wrists, and hands. Your doctor will ask about your hand pain, including possible causes, and will perform two tests that pinpoint median nerve compression.
Tapping test: Tap the inside of your wrist. Does this cause pain or shock-like tingling?
Wrist flexion : Put the back of your hands together, shoulders relaxed, with fingers pointing down for 1 minute. Does this cause your symptoms?
Inform your doctor about any health problems , strains or recent injuries to your wrist, arm, or neck. Any one of these could affect the median nerve. Describe your daily routine or anything that could have strained or hurt your wrist. Your doctor might order blood tests, which can help detect a health problem that is causing your symptoms. If there are signs or symptoms of a nerve or muscle disorder, your doctor may order an electromyography with nerve conduction testing.
Results will confirm whether your pain is related to the median nerve and not something else. If nerve entrapment is involved, your physician will discuss possible treatments with you.
When Does Carpal Tunnel Surgery Become Necessary
This procedure is the last resort. If a physician diagnoses you with carpal tunnel syndrome, you will receive nonsurgical interventions first. These treatments include pain relievers, therapies, special equipment, or steroid shots.
Unfortunately, these may not work. The pain might become too severe, and the electromyography test results may show that surgery is required. The carpal tunnel syndrome might even get worse to the point that the hands become weak already.
If the symptoms ultimately persist for six months despite the treatments, carpal tunnel surgery becomes necessary. This syndrome can get worse over time.
How Often Is Hand Pain Caused By Carpal Tunnel Syndrome
While carpal tunnel syndrome is a common condition, it has a different set of symptoms from many other sources of hand pain. There are actually several similar conditions that cause hand pain. These include:
- De Quervains tendinosis: A condition where swelling affects the wrist and base of the thumb. In this condition, you will feel pain when you make a fist and simulate shaking someones hand.
- Trigger finger: This condition causes soreness at the base of the finger or thumb. Trigger finger also causes pain, locking and stiffness when bending the fingers and thumb.
- Arthritis: This is a general term for many conditions that cause stiffness and swelling in your joints. Arthritis can impact many joints in your body and ranges from causing small amounts of discomfort to breaking down the joint over time .
Also Check: Where Is Neck Pain Located In Meningitis
How To Treat Carpal Tunnel Syndrome Without Surgery
Im writing this article for people who want to avoid carpal tunnel surgery. Yes, I am a hand surgeon but Im also a physician, and part of our jobs as physicians is to educate patients about prevention of disease. Hopefully I can teach people about ways to reduce the risk of carpal tunnel syndrome and provide options for treatment prior to requiring surgery.;As a disclaimer, patients who have severe carpal tunnel syndrome should be evaluated promptly and not delay treatment unnecessarily. Constant numbness in the hand and loss of muscle mass at the base of the thumb are signs of nerve damage and severe CTS. Surgery is the best way to prevent the nerve from being damaged irreversibly. If people wait too long before having surgery, some of the hand numbness can be permanent.;Also, not all hand pain, numbness, and tingling are caused by CTS. If your symptoms are progressive, severe, or not responding to treatment, get an evaluation by a hand specialist or primary care physician sooner rather than later. The recommendations below are intended for patients with mild to moderate CTS symptoms, or in people who want to prevent the symptoms from occurring in the first place. There are some things we cant change about our health, such as our family history, age and anatomy, but there are many things which we can modify.Helpful things to do other than surgery for carpal tunnel syndrome:
;Treatments which are NOT helpful for CTS:
Within 2 Weeks Of Discharge
This period of carpal tunnel surgery recovery lasts about 10-14 days. At the end you’ll have a follow-up visit with the surgeon. They will remove the bandages, examine the wound, and remove the stitches. You’ll also get a soft padded brace for your hand and wrist to wear for the next month.
From this point on you can drive a car and do most of the other things you could not since surgery. As a rule, this is particular carpal tunnel surgery recovery time period is important. That’s because you will begin physical therapy and hand rehabilitation programs. You will have lost significant strength and dexterity, and this time period helps restore that.
Studies showthat patients who commit to a regular hand therapy and rehabilitation program have better hand function in the long run. As you perform more and more vigorous hand activities, like going back to work, you must keep the rehab going strong.
Physical therapy stretches, range of motion exercises and hand strengthening all add up to a healthy and successful recovery. In other words, yourdrive and attitudetoward restoring your hand is crucially important.
Don’t Miss: What Doctor To See For Wrist Pain
Wearing A Brace At Night
;Most people, including myself, sleep with the wrist bent. When the wrist is not kept straight, the pressure within the carpal tunnel increases. Therefore, when the wrist is bent for a long period of time, such as during sleep, the nerve is compressed. This can cause symptoms at night. The simplest treatment is to use an over-the-counter wrist brace to keep the wrist straight and train yourself not to keep the wrist bent during sleep. Otherwise youll wake up with the hand numb/tingly and have to reposition your arm and shake out the numbness to get the feeling back.
How Long Does It Take To Recover For Carpal Tunnel Surgery
Generally, your recovery from endoscopic surgery is quicker than the open release. Regardless of the method, you should expect full recovery to take several months to a year.;
You should expect to lose grip strength following surgery since this is the most common complication. Although, people will make a full recovery and you will likely regain most of your hand strength.
Some of you may have some residual tingling or mild hand weakness. In rare cases there are complications, which include the following.
- Scar pain.
Following surgery, recurrence is rare, although there seems to be some data suggesting it is more common with endoscopic carpal tunnel surgery than with open carpal tunnel release.
Also Check: Can Asthma Cause Pain Between Shoulder Blades
What Happens During Surgery
Surgery can be performed either as an open or endoscopic technique. Both are performed as outpatient surgery, require small incisions, and take only 10 minutes. Both procedures involve cutting the carpal ligament to relieve pressure on the median nerve. Recovery varies, depending on the incision size and the patients overall health.
Does Carpal Tunnel Syndrome Have A Long Recovery
Surgery to repair carpal tunnel syndrome does not have a particularly long recovery. The bandage that covers the stitches after surgery can be removed in a few days. The hand can then be used for light activities. Making a fist is encouraged. Full range of finger motion and early symptom relief is usually seen within two weeks after the stitches have been removed. You can usually return to most activities by six weeks. Your return to work depends on factors such as type of work, how much control you have over your work and workplace equipment.
Read Also: How To Massage Shoulder Pain
What Are The Causes
Carpal tunnel pain occurs when the tendon presses on the median nerve. With inflammation, the space within the carpal tunnel shrinks, adding to the compression of the nerve. Â;
Some people, often women, have a smaller tunnel and are more at risk of developing carpal tunnel syndrome.
Repetitive movements with the wrist in an unnatural position or overuse are seen among office workers, computer/smart phone users, carpenters, assembly line workers, musicians, and some athletes. Carpal tunnel syndrome can also develop with illness , obesity, smoking, or pregnancy. It can result from trauma, an injury to the upper arm, a dislocated wrist, or a fracture.
Primary Care Physician Vs Orthopedic Hand Specialist
The reason you should visit an orthopedic hand specialist for carpal tunnel is because they have the expertise and knowledge necessary to adequately examine, diagnose, and treat hand and wrist conditions.
A primary care physician treats many different common health conditions, such as the common cold or flu. However, a PCP may not be as adept at fully, properly addressing serious conditions like carpal tunnel syndrome.
An orthopedic physician has expertise in treating musculoskeletal conditions throughout the body, including issues involving the bones, muscles, tendons, and ligaments. An orthopedic hand specialist has specific expertise in orthopedics as it relates to injuries and debilitating issues in the hand which is what makes this type of medical specialist the proper health care professional to diagnose and treat your carpal tunnel syndrome.
Read Also: Can Wrist Brace Help Carpal Tunnel
What To Expect After Carpal Tunnel Surgery
Carpal tunnel is a very painful syndrome, and once you experience symptoms, youll want to do everything you can to relieve the pain. After living with the flare-ups and pain for so long, the only option might be surgery. If your carpal tunnel leads to surgery, knowing what to expect after surgery will benefit your recovery.
Carpal Tunnel Release Surgery In Watertown Ny
Carpal tunnel release surgery to widen the space in the carpal tunnel is a relatively quick procedure and takes under an hour to complete. It also requires a fairly short recovery period before you begin to experience improvement in your symptoms and regain function in your hand.
The medical team here at North Country Orthopaedic Group regularly performs carpal tunnel release surgery in our ambulatory surgical center in Watertown. We can help you experience relief from your symptoms and prevent future disability, so you can continue doing the things you love and living a normal lifestyle.
To request a consultation with one of our orthopedists, call North Country Orthopaedic Group today at 782-1650 or fill out our appointment request form online now. We look forward to helping you recover the full use of your hands once again.
Also Check: Does Hypothyroidism Cause Stomach Pain
Reduce Or Quit Tobacco Use
Nicotine is an addictive chemical in tobacco products. It also constricts arteries and reduces blood flow in the body. If the blood flow in the hand is reduced, the nerves can be more sensitive to injury. Stopping tobacco use may reduce the risk of CTS symptoms and is good for your;overall health. Consider talking to your primary care physician about quitting.;
How Do I Prepare
As with any surgery, there are a few things you can do to prepare:
- Exercise. Our bodies tend to heal and regain function faster when they are in good physical and cardiovascular condition.
- Medicine. Before the surgery, discuss with your doctor the medicines you are currently taking. Some may need to be stopped for a few days before your surgery.
Consult your doctor for more specific planning based on your individual health condition.
Before the surgery, your doctor will explain the procedure to you and offer you the chance to ask any questions that you might have about the procedure. You may undergo blood tests or other diagnostic tests.
In addition, you need to tell your doctor:
- If you are sensitive to or are allergic to any medicines, latex, tape, and anesthetic agents .
- About all medicines you are using, including prescribed and over-the-counter medicines, herbal supplements and patches.
- If you have a history of bleeding disorders or if you are taking any anticoagulant medicines, aspirin, or other medicines that affect blood clotting.
- You are pregnant or suspect that you are pregnant.
What Can You Do Other Than Have Surgery
You can try several home treatments to help relieve your symptoms. This may be all you need to do for mild symptoms of carpal tunnel syndrome. Doctors suggest that you try these treatments for 3 to 12 months before you think about having surgery. It often helps to try several treatments at the same time.
You may try to:
- Rest your hand for 1 or 2 weeks. Stop activities that hurt.
- Put ice on the palm of your hand and wrist for 10 to 15 minutes at a time.
- Take nonsteroidal anti-inflammatory drugs , such as naproxen or ibuprofen. Studies havent shown NSAIDs to be effective for carpal tunnel syndrome, but they may help relieve your symptoms. Talk to your doctor before taking NSAIDs. They can cause side effects. Be safe with medicines. Read and follow all instructions on the label.
- Change the way you do certain hand motions.
- Wear a wrist splint. Its usually worn at night, but you can wear it during the day.
- You can work with a physical therapist to learn how to do activities in a new way.
- If these home care treatments dont help, you may be able to take corticosteroid shots or pills to improve your symptoms.
- You can try yoga.
- Symptoms of carpal tunnel syndrome in pregnant women often go away after childbirth. Unless your symptoms are very bad, you may want to put off having surgery and see if your symptoms go away after you have the baby.
Rest, ice, and other home treatments may be all you need if youve had mild symptoms for a short time.
It Is Secure And Successful To Use Both The Conventional Open Approach And The Less Invasive Approach
There were some worries that the procedure was risky and more susceptible to complications when endoscopic methods to carpal tunnel surgery were new. But current studies show that both methods are equally safe and accurate. In addition, a faster recovery period and return-to-work date can be given by the endoscopic approach. Your surgeon’s level of familiarity with your chosen approach of carpal tunnel treatment options would need the highest attention.
Make A List Of Candidates
Start by asking your family, friends, and current healthcare providers for surgeon recommendations. If youre starting without any referrals, or if youre looking for more options, search for hand surgeons on Healthgrades.com.;
Healthgrades.com shows patient satisfaction ratings, which give you insight into how your own experience might be with the doctor. Patients rate the doctor and the doctors medical practice, and say if they would recommend the doctor to family and friends.
Ignoring Symptoms Of This Carpal Tunnel Syndrome Can Lead To Permanent Nerve Damage
First, you may notice tingling or numbness in your fingers that comes and goes. Over time, the sensations may get worse, lasting longer or even waking you up at night. Eventually the pain and numbness might even make it hard to grip things like a fork, a pen, or other objects.
If you’re having these symptoms, it could be carpal tunnel syndrome, which occurs when the median nerve which runs down your arm and into your hand is compressed by a ligament that crosses over it as it passes through a narrow space in the wrist known as the carpal tunnel.
“Carpal tunnel syndrome has classic symptoms, which include numbness and tingling in the thumb, index finger, middle finger, and half of the ring finger,” says Dr. Tamara Rozental, professor of orthopedic surgery at Harvard Medical School and chief of hand and upper extremity surgery at Beth Israel Deaconess Medical Center. Your little finger is typically not affected because a different nerve serves it.
Read Also: Do Muscle Relaxers Help Sciatic Nerve Pain
Should Older Adults Have Carpal Tunnel Release Surgery
Older adults seem to have a greater chance of developing carpal tunnel syndrome and with more severe symptoms. There is plenty of research evidence to support the benefits of surgery to release the soft tissues around the affected nerve in the general adult population. But no one has really studied the results of surgical release in the older adult group.
This study looked at the surgical results for 78 adults who had carpal tunnel surgery. Each individual was carefully evaluated before surgery to make sure the diagnosis was correct. The most reliable test for carpal tunnel syndrome is a nerve conduction study. Only patients whose carpal tunnel syndrome was confirmed with nerve conduction studies were included. The surgery done was an endoscopic carpal tunnel release.
Patient charts were reviewed, data collected, and statistics analyzed. The kinds of information viewed included demographic data , clinical presentation , and patient satisfaction . Each patient filled out several surveys answering questions about pain, numbness, sleep, and daily function.
Those patients who did report pain before surgery were able to get relief from their pain following the carpal tunnel release procedure. Almost everyone who had numbness before surgery was no longer bothered by this symptom.
Dont Miss: Where Is Your Carpal Tunnel
Mayo Clinic Q And A: Recovery After Surgery For Carpal Tunnel Syndrome Whats Normal And Whats Not
DEAR MAYO CLINIC: Three months ago, I had surgery on my left wrist to treat carpal tunnel syndrome. Since then, I am in much more pain than before surgery, and two of my fingers are completely numb. I cannot even button a button, and tying my shoes is a chore. What would cause the pain to worsen after surgery? Could another surgery remedy the problem, or is this my new normal?
ANSWER: Your condition as it stands now shouldnt be considered a new normal. Its possible your symptoms are part of the recovery from surgery, and they may improve with time. It would be a good idea, however, to meet with your surgeon now, so he or she can reassess your condition and decide if you need additional tests or treatment.
Carpal tunnel syndrome is caused by compression of the median nerve within the carpal tunnel a narrow passageway on the palm side of your wrist. The median nerve runs from your forearm through the carpal tunnel and into your hand. It controls the sensations you feel on the palm side of your thumb and fingers, except the little finger. Carpal tunnel syndrome often causes numbness and tingling in the hand and arm. Surgery to treat it involves relieving pressure on the median nerve by cutting the ligament that crosses over it.
Its helpful to note, too, that nerves typically improve after surgery at a rate of about 1 inch per month. When sensation returns, it happens gradually. In general, full recovery after carpal tunnel syndrome may take up to a year.
Read Also: Can A Pinched Nerve In Neck Cause Ear Pain