What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition that causes pain, numbness, tingling, and weakness in the hand and wrist. It happens when there is increased pressure on a nerve called the median nerve. This nerve provides sensation to the thumb, index, and middle fingers, and to half of the ring finger. The small finger is not affected.

What is the carpal tunnel?

The carpal tunnel is a narrow canal or tube in the wrist. This tube allows the median nerve and tendons to connect the hand and forearm. The parts of this tunnel include:

  • Bones in the wrist make up the bottom and sides of the tunnel
  • A fibrous band called carpal Ligament makes the roof of the tunnel

Median nerve and tendons which move the fingers travel through this tunnel.

Carpal tunnel syndrome is more common in women than in men.

What causes carpal tunnel syndrome?

This happens due to compression of the median nerve within the tunnel, which can be either due to narrowing of the tunnel or due to increase in the thickness of contents of the tunnel.

When the median nerve is compressed for long time, it slowly leads to damage of nerve and loss of its functions. That means sensation over a part of hand and power of hand grip starts to come down.

How can carpal tunnel syndrome be prevented?

Carpal tunnel syndrome is difficult to prevent. Though there are many things that can be avoided to prevent this disease, most of them are part of person’s daily life avoiding them are usually not-practical.

How to diagnose carpal tunnel syndrome?

First, your doctor will discuss your symptoms and examine you. Doctor’s examination includes a few tests in which your doctor presses over your carpal tunnel or your doctor bends your wrist, so that the pressure increases within your tunnel and he will look for the reproduction of symptoms. A few other tests also will be performed, which may include:

  • X-rays of the wrist : to see whether thre is any abnormality in your bones which caused narrowing of the tunnel
  • nerve conduction studies: though the most common site of compression of median nerve is within carpal tunnel, it can happen in various other locations right from your neck and all those will produce similar problems. This study helps in conforming that the compression is happening in the wrist itself.

How is carpal tunnel syndrome treated?

Carpal tunnel syndrome can be treated in two ways: non-surgically or with surgery. Trial of non-surgical treatments are used for less severe cases Surgical treatments can help in more severe cases and have very positive outcomes.

Non-surgical treatments

Non-surgical treatments are usually tried first. Treatment begins by:

  • Wearing a wrist splint at night.
  • Taking medicines
  • Making modifications in the work

Surgical treatments

During surgery your doctor will cut (release) the ligament that covers the carpal tunnel and thereby increase the size of the tunnel in order to decrease the pressure on the nerve

Surgery is recommended when carpal tunnel syndrome does not respond to non-surgical treatments or has already become severe.

Is the surgery painful?

No. Surgery is done after giving some kind of anesthesia. Most of the doctors including us, do the surgery under local anesthesia (pain numbing medicines will be given at the site of skin cut, and you will be completely awake). Few doctors do this surgery after numbing the whole of your upper limb, right from your shoulder. Whatever the type of anesthesia, either the cut area is numbed or the whole of your upper limb is numbed you will feel no pain at all during surgery.

Does the surgery for carpal tunnel syndrome have a long recovery?

Immediately after surgery you will be given a large dressing (for the size of hand) and a bandage. These large dressings will be changed to a smaller band-aid in next day or the day after. Then you can use your hand for light activities taking care not to dirty your dressing. The stiches will be removed in 2 weeks after surgery.

Carpal tunnel syndrome surgery wound

What is the success rate for carpal tunnel syndrome surgery?

The actual aim of doing surgery in a patient with carpal tunnel syndrome is to prevent the further compression and further damage to the nerve. We are aiming to avoid further worsening of the problem.

Even then, in our experience most of the patients for whom we have done surgery reports complete or near complete relief of their problems.