What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome, also known as median nerve compression, is a condition that causes numbness, tingling sensation and weakness in your wrist or hand. This occurs when there is excessive pressure in your wrist (carpal tunnel) and on the median nerve. The median nerve provides sensation to your thumb, index, middle, and part of the ring finger.
What causes Carpal Tunnel Syndrome?
What are the symptoms of Carpal Tunnel Syndrome?
You may experience the following symptoms if you have Carpal Tunnel Syndrome:
- Burning, tingling or numbing sensation in your palm and fingers
- Weakness in one or both hands
- Difficulty in performing small manual tasks such as holding a book or phone, or when typing.
How is Carpal Tunnel Syndrome diagnosed?
A physical examination is required to assess your wrist, hand, shoulder, and neck movements to determine if there is nerve compression and alteration in sensation and muscle strength.
The specialist may also require X-rays, scans, or nerve conduction studies to confirm the diagnosis.
What treatments are there for Carpal Tunnel Syndrome?
For mild cases, resting your hand and wearing a splint can often ease your symptoms. Depending on the diagnosis and severity of your condition, your doctor may also recommend the following treatments:
Pain relievers and non-steroidal anti-inflammatory drugs can provide pressure relief and reduce swelling.
Your orthopaedic specialist may also advise you to take note of strenuous activities and hand postures that could further aggravate your condition.
Steroid injection is effective in reducing inflammation and relieving numbness in Carpal Tunnel Syndrome. The duration of effectiveness may last between weeks to months, and occasionally, years.
Some common side effects of steroid injections may include skin thinning, discolouration, or recurrence.
Surgery can be an option for patients whose condition did not respond well to non-surgical treatments. Surgery for Carpal Tunnel Syndrome aims to relief the pressure on your nerves and tendons by increasing the size of the wrist tunnel. It is performed under local anaesthesia with or without sedation. The nerve will be examined after pressure release to determine the presence of nerve scarring and blood supply. Scar tissue may be released to encourage nerve healing.
There are two types of Carpal Tunnel Release Surgery:
Open Carpal Tunnel Release
Open surgery is the most common method. An incision is made on your palm to expose the transverse carpal tunnel ligament before cutting it in half. This procedure requires a longer recovery time.
Endoscopic Carpal Tunnel Release
Endoscopic surgery may start with one or two incisions in your wrist. The doctor will then insert an endoscope with a camera through the incision to see the ligament. The number of incisions required will depend on whether a single portal or double portal technique is performed.
Similar to an open carpal tunnel release surgery, this surgical procedure aims to slice the transverse carpal ligament in half. It is less invasive compared to the open release method and has a faster recovery time.
The surgical incision usually takes about seven to 10 days to heal, while internal wounds may take longer. More than half of the patients who had carpal tunnel release surgery experience improvement of numbness within a week of surgery. Patients who had Carpal Tunnel Syndrome for many years with nerve scarring, may require a longer period to regain their wrist or hand function, as compared to patients who had the condition for a few months.
It will take some time for the muscle masses in your hand to recover to the new state after surgery. Patients may also experience pain at the surgical site (pillar pain) due to pressure over the carpal tunnel. However, most pillar pain will not last more than a few months. In symptomatic cases, injection of the scar tissue may help to relieve discomfort.
How can I treat Carpal Tunnel Syndrome at home?
For self-care at home, you may place an ice pack or soak your wrist in an ice bath for short-term relief. Do it for 10 to 15 minutes each time, up to twice an hour.
For pain that wakes you up at night, gently shake your wrist or place your hand over the side of your bed. Wearing a wrist splint during the night can also help relieve your symptoms. Another way of relieving pain is to rest your wrist and hand as much as possible to avoid triggering the symptoms.
What will happen if Carpal Tunnel Syndrome is not treated?
If left untreated, Carpal Tunnel Syndrome can cause deterioration or even irreversible damage to your nerves. Should your symptoms persist, seek treatment and consult a doctor as soon as possible.