Most patients have heard of carpal tunnel syndrome. But many patients still have questions, such as “what is carpal tunnel syndrome?” and “how did I get carpal tunnel?” Also, “What kind of doctor do I see for my carpal tunnel?”
Carpal tunnel syndrome is the most common compression neuropathy in the hand and arm. This is basically a type of pinched nerve in the wrist and hand. Patients feel tingling and “pins and needles” in the thumb, index, and middle fingers. Sometimes the whole hand can feel numb or asleep. The hand can also have burning or electric pain. Symptoms are often worse at night. Many patients wake up at night to shake out the hand for relief. Numbness and tingling are common while holding a phone, driving, typing, or gripping tools during the day.
As carpal tunnel syndrome gets worse, the symptoms become more frequent. The hand numbness and tingling can become constant all the time. In severe cases, the muscles at the base of the thumb become weak and smaller. Constant numbness in the hand and thumb muscle atrophy are signs of nerve damage.
Risk factors for carpal tunnel are: family history, diabetes, rheumatoid arthritis, thyroid disorders, pregnancy, and wrist fracture. Work related activities and computer use are controversial risk factors. Both hands can be affected by carpal tunnel, not just the dominant hand.
Hand surgeons like Dr. Erickson care for patients with carpal tunnel syndrome every day. The diagnosis is usually obvious to most experienced hand surgeons, based on patient symptoms and physical examination findings. In some cases, a nerve study/EMG is ordered to confirm the diagnosis or rule-out other neurologic conditions. Sometimes a steroid injection is used to help confirm the diagnosis.
Many patients with mild to moderate CTS can improve with non-surgical treatments. Wearing a wrist brace at night is often helpful to prevent the nerve from being pinched in the wrist while sleeping. Stretching exercises and hand therapy may help some patients. Steroid injections are often very helpful to relieve symptoms in mild to moderate cases of carpal tunnel syndrome.
If the nerve compression is severe, or if non-surgical treatment has not been successful, carpal tunnel release surgery is usually recommended. Carpal tunnel surgery is the best way to prevent nerve damage in the hand.
Carpal Tunnel Release Surgery is the most common procedure performed on the hand in the United States. The majority of patients experience improvement in the numbness and tingling in the hands at night after surgery. Over 90% of patients are satisfied with the outcome of the surgery. Complications from carpal tunnel surgery are possible but not common. If the nerve compression is severe and has resulted in nerve damage, patients do not always recover normal sensation in their hand after surgery.
Dr. Erickson has performed over 1,000 carpal tunnel release surgeries in Raleigh. He uses a limited open carpal tunnel release technique which can be performed with local anesthesia only, without the need for anesthesiologist. This is called Wide-Awake Local Anesthesia No Tourniquet (WALANT). For patients with anxiety, oral Valium or IV sedation are available as well.
Consider an appointment with Dr. Erickson at the Raleigh Hand to Shoulder Center to discuss your treatment options for carpal tunnel syndrome.