Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is one of the most common conditions affecting the hand and wrist. It causes numbness, pain, and loss of hand function.

CTS occurs when the major nerve that serves the hand becomes compressed in a tunnel formed between a ligament and the bones of the wrist. This nerve is responsible for most of the feeling in the hand, and its ability to grip and pinch.

CTS frequently is associated with repetitive hand movements, such as keyboard or computer mouse activity. It also can occur as a result of fluid retention during pregnancy, or as a result of some other medical conditions such as diabetes, hypothyroidism, and rheumatoid arthritis. Most often, however, the cause is not known.

Classic symptoms of CTS include:
• Numbness and/or pain in the palm of the hand and fingers
• Worsening of symptoms at night
• Weakened grip

A Nerve Conduction Study is sometimes used to help diagnose CTS and to rule out other possible causes.

Treatment of CTS depends on severity as well as other factors. Conservative management (splinting, medication, and activity modification) is generally tried first, particularly in mild cases.

When symptoms persist despite conservative treatment, surgical treatment is often appropriate. Surgery for CTS is done as an outpatient under local anesthesia, with sedation. A short incision is made in the palm, and the tightness in the tunnel is released by dividing the ligament. Relief of pain and numbness is usually immediate, unless the nerve has been damaged by longstanding compression.

A wrist splint is worn after surgery for about 9 days, with light activity allowed almost immediately. Most patients are able to resume their usual activities after three weeks.
Carpal Tunnel Sensory Loss
Pattern of Sensory Loss

Carpal Tunnel Incision
 
Carpal Tunnel Incision