What You Should Know About Carpal Tunnel Syndrome According to Hand & Upper Extremity Surgeon Archit V. Patel, MD

If you’re experiencing pain or numbness in your hand or wrist, you may have a common condition affecting 4-10 million Americans.  Whether it’s caused by repetitive activity or an injury, the good news is the condition, Carpal Tunnel Syndrome, can be easily treated.

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome, commonly referred to as just Carpal Tunnel, is the most common nerve compression that affects the upper extremity; hand, arm, and shoulder. It results in pain, weakness, and numbness in the hand. Left untreated, the condition can lead to lost sensation and atrophy, which is the breakdown of tissue of some muscles to the thumb. There are multiple causes of the increased pressure on the median nerve within the carpal tunnel resulting in carpal tunnel syndrome.

Causes for Carpal Tunnel

Symptoms can occur acutely from trauma, high pressure injuries, or infection and result in the need for emergent surgery. However, most cases of Carpal Tunnel Syndrome are chronic and have a gradual onset. Most commonly the condition doesn’t have an identifiable cause; however can also be caused by chronic infections, tumors, alcoholism, diabetes, hypothyroidism, rheumatory arthritis, among other things.

Sometimes, the cause of Carpal Tunnel is considered to be work related if the profession includes a lot of vibrations and exertions.  Studies show that increased flexing and extension can lead to increased pressure on the median nerve. While many believe typing and texting can cause this condition, there is still no definitive evidence that proves this to be true. 

Diagnosing Carpal Tunnel

The diagnosis of carpal tunnel is heavily dependent on the history and physical exam. Objective tests such as an EMG (Electromyography) and NCS (Neve Conduction Study) help to verify and confirm diagnosis and rule out other sites of compression (i.e. cervical spine). These studies provide additional information about the severity as well.

Treatment

Treatment often depends on how Carpal Tunnel Syndrome is presenting itself. The most common presentation is a nighttime awakening of hand pain and numbness. This is initially treated with night time bracing to limit wrist flexing and extension that we often do which leads to the transient increase in pressure on the median nerve while sleeping.

While the definitive treatment of carpal tunnel syndrome is surgical treatment, there are some treatments that can provide temporary relief. These include steroid injections, pain medication, and wearing a splint. In mild cases, these treatments may be all a patient needs.  There are multiple surgical techniques if your pain is severe enough to require surgery. A hand surgeon may decide to perform an open procedure or an  endoscopic carpal tunnel release; both can be done on an outpatient basis. At Crystal Run, we perform these procedures in the Ambulatory Surgery Center in Middletown. The goal of these surgeries is to alleviate the pressure on the median nerve.

Whether your pain is mild or severe, you shouldn’t put up with it another day. Our coordinated approach to care at Crystal Run allows us to work as a team, whether you need treatment from a Hand Surgeon, a Physical Therapist, or both, we’ll work together to get you back to health. 

Archit V. Patel, MD, is a Fellowship-trained Orthopedic Hand & Upper Extremity surgeon. He earned his Medical Degree from Washington University in St. Louis, MO and completed his Residency in Orthopedic Surgery at Maimonides Medical Center in Brooklyn, NY. Dr. Patel is Board Certified in Orthopedic Surgery and completed Fellowship training in Orthopedic Hand & Upper Extremity at University of Chicago in Chicago, IL. He provides care to patients for a variety of hand conditions and injuries at Crystal Run’s Newburgh and New Windsor locations.

Additional Source:

Rheumatology.org