FAQ’s on Carpal Tunnel Syndrome Treatment in Philadelphia
The carpal tunnel is a small tunnel that runs along the forearm. This narrow passageway is composed of bones and ligaments, and it houses the median nerve and tendons. Carpal tunnel syndrome (CTS) occurs when the median nerve and wrist structures become compressed.
What is the median nerve?
The median nerve is used to control sensations to the fingers (except the little fingers) and thumb, on the palm side. This nerve becomes irritated when traumatized or compressed.
What are the symptoms of carpal tunnel syndrome?
The symptoms associated with CTS include tingling, burning, and/or itching of the palm of the hand and fingers, particularly the index finger, middle finger, and thumb. People with this syndrome report that their fingers feel swollen and useless. Many people report clumsiness, dropping things, and numbness. A common finding is noted decreased grip strength, which makes it hard to grasp tiny objects, make a fist, or button clothes.
What causes carpal tunnel syndrome?
A combination of factors contribute to the development of CTS. This disorder is often the result of a congenital predisposition, where the carpal tunnel is smaller than it should be. Over-activity, injury, and trauma also lead to the syndrome. In addition, contributing factors include work stress, hypothyroid, pituitary gland dysfunction, a sprain or fracture, fluid retention, menopause, and/or the development of a cyst or tumor in the canal.
What are the risk factors for carpal tunnel syndrome?
- Female gender – Women are three times more likely than men to develop CTS.
- Having diabetes or thyroid disease – People with diabetes or other metabolic conditions are at risk.
- Advancing age – CTS affects adults.
How common is CTS?
Based on statistics from the 2010 National Health Interview Survey, around 3% of the general population have CTS, which is around 5 million working people.
How is carpal tunnel syndrome diagnosed?
The doctor will conduct a physical examination of the fingers, hands, arms, shoulders, and neck to diagnose the underlying disorder and rule out other painful conditions. Routine x-rays are done to assess for arthritis and fractures, and laboratory tests are done to check for diabetes, thyroid disorder, and syndromes. An electro-conduction study is done to measure nerve impulses, and electromyography will check the damage to the median nerve.
What are the treatment options for CTS?
The treatment options for this syndrome include:
- Medicines – Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. In addition, a short course of steroids is often prescribed to decrease inflammation. Oral diuretics will decrease swelling. Topical agents can be applied to the wrist to decrease pain, such as capsaicin, menthol, and camphor.
- Physical therapy – The therapist will teach strengthening and stretching exercises, and assist the patient to use adaptive devices as necessary.
- Brace or splint – The doctor may prescribe a brace or splint, which can be worn during activities or night to keep the wrist in a neutral position.
- Corticosteroid injections – For long-term pain relief, the doctor may inject a corticosteroid into the carpal tunnel. This will reduce inflammation and swelling. A clinical study found that these injections have a 77% success rate, and the majority of patients enjoyed pain relief for up to six months.
- Carpal tunnel release surgery – This is one of the most commonly performed surgical procedures in the U.S. The doctor will cut the carpal ligament to make room for the tendons and median nerve in the carpal tunnel.
Luckhaupt SE, Dahlhamer JM, Ward BW (2010). Prevalence and work-relatedness of carpal tunnel syndrome in the working population, United States, 2010 National Health Interview Survey. Am J Ind Medicine, 56(6), 615-624.
Mintalucci DJ & Leinberry CF Jr. (2012).Open versus endoscopic carpal tunnel release. Orthop Clin North Am, 43(4):431-7.
Visser, L. H., Q. Ngo, et al. (2011). Long term effect of local corticosteroid injection for carpal tunnel syndrome: A relation with electrodiagnostic severity. Clinical Neurophysiology.