Pain, numbness, and tingling of the hand and forearm are symptoms of carpal tunnel, a condition when the median nerve in the hand has become compressed. In most cases, this condition only gets worse over time so early diagnosis is critical to restoring nerve health and function.
What is Carpal Tunnel Syndrome?
The wrist is comprised of a narrow passageway that’s surrounded by small wrist bones, or carpal bones. The top of the tunnel is made of a band of connective tissue and the median nerve, one of the main nerves of the hand, runs all the way from the neck down the arm and forearm, through the carpal tunnel, and into the hand. When the carpal tunnel becomes narrow or the tissues around the median nerve swell up, the pressure can squeeze the nerve which in turn causes pain, weakness, and tingling of the hands and arm.
Most cases of carpal tunnel syndrome are caused by a combination of factors, including: genetics, repetitive hand use, hand and wrist position, pregnancy, and certain health conditions. Symptoms include numbness and burning, a shock-like sensation that radiate to the extremities in the hand, pain or tingling in the forearm and shoulder, and weakness in the hands.
Carpal tunnel syndrome usually begins slowly, and may be a result of a specific injury. However, symptoms can get worse over time and symptoms may be more apparent at night.
Treatment for Carpal Tunnel Syndrome
In the early stages, many patients find that simply moving and shaking their hands relieve some of the symptoms. Increasing range of motion and performing wrist exercises can help reduce pain and discomfort. However, symptoms may be warning signs of a deeper problem.
During an evaluation, Dr. Kilaru will examine the hand and wrist and perform several physical tests to determine whether your range of motion is compromised. He may bend and flex the wrists, press along the median nerve, and look for signs of atrophy around the base of the thumb. Electrophysiological tests, ultrasound, X-rays, and magnetic resonance imaging (MRI) scans can provide more details about any ligament injuries, signs of arthritis, or fractures.
If diagnosed early, carpal tunnel can be treated without surgery. Activity changes, wearing a splint or a brace, nerve gliding exercises, and steroid injections can help relieve symptoms. Making lifestyle and activity changes can protect the nerve from further damage. If the condition is very severe, surgical treatment may be needed. Surgery can release the carpal tunnel by cutting the ligament that forms at the roof of the tunnel, thereby increasing the size of the tunnel and decreasing pressure on the median nerve.
What to Expect with Carpal Tunnel Surgery
Most people need about 2 or 3 months to regain full sensation and control of their wrist and hand after surgery. Grip and pinch strength can take up to 12 months to be restored if the median nerve was in very poor condition. A splint or wrist brace must be worn for several weeks after treatment and you must avoid using your hands to lift heavy objects or grip things tightly during the healing phase.
Recovery from surgery will be gradual but most patients have a significant improvement in symptoms after surgery. Early treatment is essential for a full recovery. If you have symptoms of carpal tunnel syndrome or think you may need surgery, schedule a consultation with Dr. Kilaru today.
