Carpal tunnel syndrome is a condition in which the median nerve is compressed as it passes through an opening from the wrist to the hand called the carpal tunnel. The carpal tunnel is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist. Since the median nerve provides sensory and motor functions to the thumb and three middle fingers, many symptoms may result.
Carpal tunnel is diagnosed through:
x-ray, MRI, CT scan
difficulty making a fist
difficulty gripping objects with the hand(s)
pain and/or numbness in the hand(s)
"pins and needles" feeling in the fingers
swollen feeling in the fingers
burning or tingling in the fingers, especially the thumb and the index and middle fingers
pain and/or numbness that is worse at night, interrupting sleep
Treatment may include:
splinting of the hand (to help prevent wrist movement and decrease the compression of the nerves inside the tunnel)
oral or injected (into the carpal tunnel space) anti-inflammatory medications (to reduce the swelling)
changing position of a computer keyboard, or other ergonomic changes
surgery (to relieve compression on the nerves in the carpal tunnel)
Surgery can be performed in the traditional open manner or endoscopically, which is minimally invasive. During both procedures, the transverse carpal ligament is cut. This release the pressure on the median nerve, relieving carpal tunnel symptoms.
In open surgery, the incision is made at the base of the palm, allowing the doctor to see the transverse carpal ligament. After the ligament is cut, the skin is closed with stitches. The gap where the ligament was cut is left alone and eventually fills up with scar tissue.
In endoscopic surgery, a thin, flexible tube with a camera attached (endoscope) is guided through a small incision in the wrist The endoscope is guided through a small incision in the wrist (single-portal technique) or at the wrist and palm (two-portal technique). The endoscope lets the doctor see structures in the wrist, such as the transverse carpal ligament, without opening the entire area with a large incision.
Physical Therapy is a critical part of complete recovery. Our doctors recommend DMC's Rehabilitation Institute of Michigan, with 30 convenient locations across southeastern Michigan. To find one near you, click here.