That tingling and numbness radiating from your wrist to your palm and fingers was probably no big deal at first. After all, you could literally shake it off by shaking your hand. But lately, you’ve noticed that uncomfortable feeling has become painful and you’re losing your grip strength. The bad news: You might have carpal tunnel syndrome (CTS). The good news: CTS can be treated.
Carpal tunnel syndrome doesn’t usually go away on its own. As a matter of fact, if left untreated, CTS often gets worse. In some of the more severe cases, muscles in the thumb actually waste away and people lose their ability to sense hot and cold with the affected hand.
CTS occurs when tendons in your hand swell and pinch your median nerve. The median nerve runs from your forearm into the palm of your hand. This nerve and the flexor tendons that bend your fingers pass through a narrow channel of bone and connective tissue called the carpel tunnel. The key word here is narrow. When the tendons swell, there’s no room in the tunnel for your median nerve. As it gets squeezed, your CTS begins.
Most of the treatments for CTS focus on relieving the pressure on the median nerve. Therapy can range from over-the-counter anti-inflammatories that reduce tendon swelling to surgery that enlarges the carpal tunnel.
Medications may relieve pain and swelling. In mild to moderate CTS, aspirin, ibuprofen, or naproxen sodium can reduce your pain and swelling. However, these drugs won’t alleviate numbness and tingling in your fingers or muscle weakness.
If over-the-counter medications don’t work, your doctor may decide to inject a steroid such as cortisone into your hand. While a steroid will immediately reduce the tendon swelling that’s putting pressure on your median nerve, the effects will last only about six months.
Restraint and rest can ease irritated tendons. Wearing a brace or split will keep you from moving your wrist and hand in ways that further irritate your already swollen tendons. This can be particularly important at bed time. Many CTS sufferers notice their symptoms flair up while their sleeping. If you often wake up at night with a numb or tingling hand, it’s probably because you’re sleeping with your wrist bent. Wearing a brace will keep your wrist still and straight.
If restraint and medications don’t work, your doctor may advise you may need to eliminate or alter the hand and wrist movements that prompt your symptoms. Following this advice may mean you’ll have to make some difficult lifestyle choices. For instance, if your occupation requires you to perform the same repetitive movements with your wrist and hand, you may need to change the type of work you do. Or, if you use vibrating power tools, you may need to stop using those types of tools.
CTS can be caused by another health condition, including diabetes, rheumatoid arthritis, and thyroid problems. If your doctor finds your CTS originated in an as-yet-untreated illness, she’ll begin your therapy by treating that medical condition.
When all else fails, surgery. If no other course of therapy is easing or eliminating your CTS symptoms, having surgery that will lessen the pressure on your median nerve may be the only cure. During the operation, an orthopaedic surgeon will cut open the ligament that covers your carpal tunnel. This expands the width of the tunnel, eliminating the tight squeeze on your median nerve.
The surgery is usually done on an outpatient basis under local anesthesia. You’ll probably need to wear a wrist brace for the first few weeks after the operation. Although full recovery may take up to a year, your grip strength will probably return within two to six months.