Understanding Carpal Tunnel Syndrome

The carpal tunnel is a narrow, fibrous passage in the wrist that protects the median nerve. This is the nerve responsible for movement and sensation in the hand and thumb, index and middle fingers. When there is a change in tissue position, the tunnel can become congested, leading to tingling and numbness in the fingers — carpal tunnel syndrome. Our Texas Neurosurgery team can open up this congestion and head off possible loss of strength and dexterity in the fingers. The outpatient procedure is called a carpal tunnel release.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome basically comes down to crowding through the carpal tunnel. Anything that decreases the amount of space in the carpal tunnel, increases the amount of tissue in the tunnel, or increases the sensitivity of the median nerve can lead to carpal tunnel syndrome. This causes the carpal tunnel to squeeze and compress the median nerve. This is known as nerve impingement or entrapment and can lead to numbness, tingling, pain, and weakness in the affected fingers and thumb of the hand. It’s important to note that carpal tunnel does not affect the pinky finger. If that finger is numb and tingling, that means another nerve is being impinged.

Symptoms

People who have repetitive jobs using their hands often suffer from carpal tunnel syndrome, and it affects women more often than men. The condition usually begins as an ache in the wrist that may extend down to the forearm or up to the hand. As carpal tunnel syndrome worsens, the patient may experience tingling or numbness in the fingers or pain radiating through the entire arm. The tingling is a sign of issues with the nerve, and this can lead to weakness in the hand in question along with difficulty grasping small objects.

How we treat carpal tunnel syndrome

We have two goals when treating your carpal tunnel syndrome: to allow you to return to your normal function and activities, and to prevent nerve damage and the corresponding loss of muscle strength in your fingers and hands.

Our first treatments are conservative:

• Anti-inflammatory drugs
• Splints
• Physical therapy
• Utilizing cold packs to reduce inflammation through the carpal tunnel
• Corticosteroid injections

If these methods do not stop the pain and tingling in the fingers, our next option is to surgically relieve the pressure on the median nerve.

Carpal tunnel release

In carpal tunnel release the goal is to relieve pressure on the median nerve and reduce symptoms of carpal tunnel syndrome. The procedure can restore muscle strength and dexterity.

We perform the procedure in two ways: endoscopically or through an open procedure. Which method we opt to perform depends on the individual situation of each patient.

Open carpal tunnel release involves a two-inch incision in the middle of the palm. This provides the surgeon a better view of the treated area and involves less risk of accidentally damaging nerves in the area.

Endoscopic carpal tunnel release involves only two tiny incisions and makes for less post-operative pain and a faster return to work. There may be a slightly higher chance of needing another surgery down the road.

If you’ve begun to notice tingling in your fingers and pain in your wrist, you could be developing carpal tunnel syndrome and we should see you at Texas Neurosurgery. Call us at (214) 823-2052 to set up your appointment.