All about Carpal Tunnel Syndrome and its treatment
Overview
Carpal tunnel syndrome is a common neurological condition characterized by a burning sensation and tingling in the hand. It may also cause pain and numbness in your fingers and hand. The condition is caused due to the application of pressure on your median nerve. This is the main nerve of your hand and forearm. The median nerve runs from below your arm, all the way to the hand via the carpal tunnel passage in your wrist. The median nerve is actively involved in controlling the feeling on your thumb. It also controls all the movements on your fingers, and especially the thumb. Carpal tunnel syndrome may also result in a sharp, piercing pain that moves up the wrist, and into the arm. The median nerve comes under pressure as a result of swelling of the tissue inside the carpal tunnel.
Carpal tunnel syndrome deteriorates over time, at least for most patients. For this reason, it is important that you get a proper diagnosis in good time so that treatment can commence immediately. During the early stages of carpal tunnel syndrome, wearing a wrist splint will help relieve symptoms of this condition. It may also be necessary to avoid certain activities that can increase pressure on the median nerve. In the event that the median nerve continues to experience pressure, this might exacerbate the symptoms, resulting in nerve damage, among other complications. Your surgeon might recommend surgery to relieve pressure from the median nerve. This will avoid permanent damage.
What causes carpal tunnel syndrome?
It is not always clear what causes the swelling of the median nerve. Sometimes, the tissues could swell after overusing or overextending’ the joint. This can be triggered by twisting or exerting too much pressure on the wrist. The tissue may also swell after you have engaged in repetitive activities that will result in too much vibration of your wrist. Examples of such repetitive activities including using a jackhammer. Typing also involves repetitive motion and as such, can cause carpal tunnel syndrome.
Heredity: Some people are born with a smaller carpal tunnel. This is likely to result in a pressure build-up in the median nerves. This could be hereditary
Wrist and hand positions: Engaging in activities that involve extending your wrists or hands for a long time may also cause pressure to build upon the nerve.
Health conditions: Individuals suffering from such chronic conditions as thyroid gland imbalance and rheumatoid arthritis are also at risk of carpal tunnel syndrome. Diabetics are also predisposed to the condition.
Pregnancy: Pregnant women are also predisposed to carpal tunnel syndrome. This is due to hormonal changes that may trigger swelling of the median nerve.
Anatomic factors: Deformed wrist bones due to dislocation, arthritis, or a fracture may lead to changes in the space within your carpal tunnel. Consequently, the median nerve comes under increased pressure.
Gender: Women are more prone to carpal tunnel syndrome, in comparison with men. This might be because women generally have a smaller carpal tunnel area as compared to men
Body fluid changes: Change in body fluid, such as the case with fluid retention, can lead to pressure build-up within your carpal tunnel. As a result, the median nerve gets irritated. Fluid retention is common during menopause and pregnancy.
What are the symptoms of carpal tunnel syndrome?
Carpal tunnel syndrome may present with the following signs and symptoms:
- Abnormal sensation: You are likely to experience a tingling or numbness in certain parts of your hand. The parts that are most affected include the three middle fingers and your thumb
- Painful fingers: You are likely to feel pain in your finger. Such pain can be felt in the arm and entire hand
- Difficulty in gripping something with your hand
- Clumsy hands and weakness: As a result, you may have difficulty doing regular activities, such as tying your shoelaces, or buttoning your shirt
- Dropping things: You might lose awareness of your hand in space, or feel weak and numb. This can cause you to drop things in your hand as the grip weakens
In almost all cases, the symptoms associated with carpal tunnel syndrome start slowly and worsen with time. Initially, the symptoms may come and go but the frequency of occurrence increases as time goes by.
You are also likely to manifest night-time symptoms. The vast majority of individuals usually bend their wrists while asleep. This can awaken you from your slumber. During the daytime, you are likely to experience symptoms while holding something in your hand for long durations. During such a time, the wrist will often bend backward and forward. Examples of activities that might result in wrist bending include driving or using a phone. For most patients, shaking or moving of hands has been shown to relieve the symptoms.
Diagnosing carpal tunnel syndrome
Physical examination
To diagnose carpal tunnel syndrome, your doctor will need to conduct a physical examination. The evaluation also involves understanding your medical history. Your doctor may also be interested in discussing your general health. The doctor will then carefully examine your wrist and hands. Some of the physical tests that you can expect during this evaluation include:
- The doctor will press down your wrist, and tap the wrist from the inside to check for tingling or numbness
- Bend your wrist and hold it down to further check for tingling or numbness
- Touch your hand and fingertips lightly using a special instrument. The goal is to test for sensitivity
- Check the base of your thumb and the surrounding muscles. This is to determine whether your thumb muscles have weakened
- Your doctor will also check for muscle atrophy at the base of the thumb
Electrophysiological tests
Through these tests, your doctor is in a position to determine if your median nerve is functioning well. Your doctor can also establish if the nerve is under too much pressure. Electrophysiological tests encompass the following:
- Electromyogram: This test determines muscle or nerve damage by establishing the electrical activity in your muscles
- Ultrasound: The test relies on sound waves at high frequencies to develop an image of the tissues and bone. This can be useful in determining signs of compression in your median nerve
- MRI scan: This test offers better images of the soft tissues in your body. An MRI is useful as it enables your doctor to establish other causes of your symptoms. Additionally, an MRI can reveal abnormal tissues that might affect the median nerve.
Treating carpal tunnel syndrome
If the carpal tunnel syndrome is mild to moderate in terms of severity, your doctor may recommend using a splint to treat the condition. You need to wear the splint at night. It ensures that your wrist will not bend too far. Your doctor will also recommend that you stop engaging in activities that might trigger the development of carpal tunnel syndrome.
Your doctor may also inject a corticosteroid into your carpal tunnel. Although such an injection may offer relief, albeit temporarily, it is not a long-term solution for the medical problem. Painkillers, including ibuprofen and paracetamol, also offer short-term relief to the pain caused by carpal tunnel syndrome. However, such medication does not address the actual causes of carpal tunnel syndrome. Therefore, you should not rely on medication as a long-term solution.
Exercising your hand can also reduce the symptoms due to carpal tunnel syndrome. Again, this is a short-term solution.
If all the above non-surgical treatment fails, your doctor will recommend that you undergo a surgical procedure to correct this problem. Such a decision depends on the severity of your symptoms. A surgical procedure protects against irreversible damage to your hand.
The surgical procedure will involve cutting the ligament found at the base of the tunnel. This will help relieve the pressure off the median nerve. The procedure also results in an increase in the size of the tunnel. Consequently, there is pressure reduction on your median nerve. Your surgeon will conduct the carpal tunnel surgery as an outpatient procedure. It is conducted under local or general anesthesia.
Open carpal tunnel release
Your doctor will make a small incision in the palm of your hand. This allows the surgeon to view your wrist and hand via the incision. Next, the surgeon divides the regions near the top of the carpal tunnel. This part is called the transverse carpal ligament. The procedure helps to increase the size of the carpal tunnel. There is a resultant decrease in pressure build-up on your median nerve.
Endoscopic surgery
During this procedure, the surgeon makes portals or small incisions on your skin. The surgeon then inserts an endoscope. This is a miniature camera that allows the surgeon to clearly see the inside of your wrist and hand. The surgeon then divides the transverse carpal ligament using a special knife. This creates more space in the carpal tunnels, in effect relieving the pressure on the median nerve.
Your surgeon will discuss with you beforehand, all the benefits and risks associated with any of the surgical procedures mentioned above, so that you can make an informed decision.
Laser surgery
Carpal tunnel syndrome can also be treated using laser surgery. The procedure involves the use of laser energy that creates a photo-bio-stimulative effect. Some of the benefits associated with laser surgery compared to the other surgical procedures include reduced time in performing the surgery. The procedure also minimizes the risk of infection and recurrence. Since laser treatment is less invasive, the healing process is faster. For these reasons, laser surgery is preferred over other surgical procedures.
Post-op care and diet
After surgery, we will make arrangements to have you transported back home in our hospital van. Your surgeon will give you the following guidelines:
- You may experience stiffness, pain, and swelling following a surgical procedure. Painkillers help relieve such pain
- You need to move your fingers to avoid stiffness and minimize swelling
- Keep your hand in an elevated position
- It may be necessary to wear a wrist brace or splint for a few weeks post-surgery
- You can use the hand in performing light activities
- Any discomfort or irritation to the hands and fingers might affect recovery
- No dietary restrictions after surgery to aid the recovery of carpal tunnel syndrome
The minor soreness can persist for a few weeks or months but will subside with time. Most patients will resume their pinch and grip strengths within 2 to 3 months of the procedure. On the other hand, patients whose median nerve was in a poor condition prior to surgery may take up to 12 months before their pinch and grip strength resumes. We will keep all our communication lines open and also check on you to see how you are progressing after surgery. In case you develop any complications while recovering at home, such as severe pain in your hand or wrist, call your surgeon immediately.
Carpal tunnel syndrome manifests in numbness and tingling in your arm. The condition can be painful, especially if the kind of work you do entails exerting pressure on your wrist. This may impact your daily work routine, not to mention your overall wellbeing and general happiness. Some of the suggested home remedies include ice and over-the-counter medication like ibuprofen. However, these only offer short-term relief. Ultimately, you will need a long-term solution to this medical problem.
- Our medical professionals at goficure are highly experienced and skilled in treating carpal tunnel syndrome.
- We offer one of the most advanced treatment programs for treating carpal tunnel syndrome in Bangalore.
- We will guide you on the most appropriate treatment for the condition.
- We often recommend laser therapy, as it is associated with increased blood flow, is non-invasive, and highly effective compared to conventional surgery.
- Additionally, we have some of the most advanced laser surgical equipment in Bangalore. At goficure, we will schedule your consultation with highly skilled doctors in Bangalore so that you can benefit from an accurate diagnosis and get the right recommendation for treatment.
- We also make arrangements to have you picked from home, help you prepare for the surgery, and liaise with specialty hospitals in Bangalore for the procedure.
- We will also drive you back home after the surgery and help get your medical insurance processed.
- Our post-op consultation is one of the most efficient in Bangalore.
- Our nutritionist will offer you personalized diet plans to assist with quick recovery.
- Our communication lines are always open in case you develop any complications.
Exclusive features you get with goficure
1. Dedicated Medi-Pal
A dedicated Medi-Pal is assigned to you. Your Medi-Pal will be your one point contact throughout the treatment and post-op period. They will always be available for you
2. Quick doctor’s appointments
After understanding your concerns, your Medi-Pal will schedule your consultation with a specialist doctor. Your doctor will carry out necessary tests and advise the course of treatment
3. Hassle-free treatment
If you opt to get the surgery done, goficure will take care of it completely. Right from booking your surgery, claiming your insurance to being with you throughout the procedure, your Medi-Pal will do it all
4. Post-op recovery support
Your Medi-Pal would ensure quick recovery. This includes booking your follow up consultations and helping you with doctor-recommended steps for diet & exercise
Guarantees
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Why Goficure?
Specialist doctors
Our doctors are vetted for their experience and skills. Rest assured, you are in safe hands. The best treatment for your condition is delivered all the time
Medi-Pal assistance
A dedicated Medi-Pal is assigned to take care of the entire process. This includes booking your appointments, scheduling the surgery, handling your documentation including claiming insurance, discharge, and post-op recovery
Affordability
Goficure delivers high-quality treatment to you at affordable prices. Superior treatment and best quality of service is assured while keeping costs reasonable
Post procedure care and follow-ups
Our engagement doesn't end after your surgery. It continue until you go back to your normal life. Free diet and exercise consultations during your recovery phase are offered to ensure a quick recovery
Comparison
With so many options, are you wondering what the right choice for your condition is? While you can opt for either an open surgery or a laser surgery, numerous studies have shown that laser surgeries are far more effective. Be it the duration of the procedure, post-operative pain or recovery time, laser surgeries always outrank open surgeries and are therefore, a better choice. Here is a quick comparison that will help you decide your course of action.
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