Carpal tunnel syndrome

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Carpal tunnel surgical procedure

Carpal tunnel syndrome

Compression of the median nerve

Surface anatomy - normal wrist

Median nerve dysfunction

The first line of treatment often involves a splint to stabilize the wrist. The splint is worn at night for several weeks. If this does not help, you may need to wear the splint during the day. Hot and cold compresses may also be recommended.

There are many ergonomic devices that can be used in the workplace to reduce the stress placed on the wrist. These include special keyboards, cushioned mouse pads, and keyboard drawers. Make sure the keyboard is low enough so that the wrists aren't bent upward during typing. You may also need to make changes in your work duties or recreational activities. Some of the jobs associated with carpal tunnel syndrome include those that involve typing and vibrating tools. Carpal tunnel syndrome has also been linked to professional musicians.

MEDICATIONS

Medications used in the treatment of carpal tunnel syndrome include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Corticosteroid injections, given into the carpal tunnel area, may provide dramatic relief of symptoms.

SURGERY

Carpal tunnel release is a surgical procedure that cuts into the ligament that is pressing on the nerve. Surgery is successful about 85% of the time. After surgery, the damaged nerve must heal for the symptoms to improve. This can take months. In severe cases, the nerve may not be able to fully heal. Certain types of damage (such as muscular atrophy) may not be reversible.

In severe cases, electromyography or nerve conduction studies may be used to check how well the nerve is recovering.

Symptoms often improve with treatment but more than 50% of cases eventually require surgery. Surgery is often successful but full healing can take months.

If the condition is treated properly, there are usually no complications. If untreated, the nerve can be damaged, causing permanent weakness, numbness and tingling.

Call for an appointment with your health care provider if you have symptoms of carpal tunnel syndrome.

Call your health care provider if symptoms of carpal tunnel syndrome do not respond to treatment, or if there seems to be a loss of muscle mass in the fingers.

Review Date: 09/26/2006
Reviewed By: Andrew L. Chen, M.D., M.S., Orthopedist, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network.