Pain-Relieving Treatments for Carpal Tunnel
January 12, 2023
There’s a common, painful problem involving the hands and wrists called carpal tunnel syndrome. This problem affects more women than men and increases in frequency over the age of 30. This blog will look at the anatomy of the wrist, explain the cause of carpal tunnel syndrome, and explore treatment options.
The Anatomy of Your Wrists
The wrist is comprised of the two long bones of the forearm, called the radius and ulna, and eight cube-shaped bones. This combination of bones makes for a very flexible yet durable structure. The structure is so delicate that it lets an artist play the violin or a weightlifter support hundreds of pounds.
The two forearm bones provide rotation that allows us to rotate from palms-up to palms-down. The eight smaller bones allow the wrist to bend back and forth and from side to side.
What is the Carpal Tunnel?
The carpals have tunnels with floors and sides formed by the wrist bones. The roof of the tunnel is comprised of a band of tissue that runs across the wrist sideways. Vital structures pass through these tunnels, including the nerves, blood vessels, and tendons that move our fingers.
Sometimes, the nerve that travels through the carpal tunnel is compressed, which causes tingling, numbness, and pain in the hand and fingers near the thumb.
Diagnosing Carpal Tunnel Syndrome
Carpal tunnel syndrome represents the collective symptoms and features that occur when the nerve is compressed:
- Numbness that wakes someone from sleep
- Weakness with gripping
- Pain that radiates into the forearm and arm
- Difficulty with fine movements like buttoning a shirt
These symptoms generally begin gradually and are intermittent. With time, they usually grow in intensity and last longer, until the hands feel numb constantly.
What Causes Nerve Compression?
The relationship of carpal tunnel to work activities is controversial. This syndrome was long thought to be a result of repetitive gripping, vibration from power tools, or using typewriters and keyboards.
One problem with this theory is that not all persons who have intense hand use at work develop carpal tunnel syndrome. Additionally, many people develop the condition with relatively limited hand use.
Those Most At Risk
While there is no exact cause of carpal tunnel syndrome, there are many features that are common with those who have it. It is frequently seen in families, and it may be due to the physical features passed from one generation to the next. Physicians also find carpal tunnel in people with similar lifestyles or years of similar hand use.
Some hormone changes that occur in women may also cause carpal tunnel syndrome. These hormonal changes often cause fluid retention and can be a result of:
- Pregnancy
- Diabetes
- Thyroid gland disorders
- Rheumatoid arthritis
The more conditions that someone has, the greater their risk of developing carpal tunnel syndrome. Symptoms are often worse with positions or activities that put greater pressure on the wrist. These include:
- Sleeping postures where the wrist is flexed down
- Gripping activities such as holding a telephone or driving
Changing position or relaxing the hand will often make the symptoms go away. Identifying a frequent situation where the symptoms occur and then avoiding it has proven helpful for treating carpal tunnel syndrome.
Medical Treatments for Carpal Tunnel Syndrome
Treatment options for carpal tunnel syndrome include:
- Braces or splints to help decrease nerve pressure
- Changes or modifications in daily hand use or job requirements
- Oral medications that relieve mild pain and decrease inflammation
- Injectable medications that shrink inflamed tissues
In extreme cases, surgery can release the pressure by opening the roof of the tunnel and dividing the band the forms it.
The Importance of Early Treatment
When carpal tunnel syndrome is identified and treated early, many times it can be treated successfully without the need for surgery. The longer the symptoms are present, the less likely they are to improve without surgery.
Because carpal tunnel symptoms are caused by pressure on the nerve, physical damage may occur in the nerve and even with surgical treatment, there may be permanent changes to the nerve that will not improve after surgical release.
Surgery for Carpal Tunnel
Surgical treatment for carpal tunnel syndrome involves dividing the band forming the roof of the carpal tunnel. After the band is cut, it heals with a larger dimension and decreases the pressure in the tunnel.
This surgery is like loosening a belt after eating a large meal. Hand use following surgery will be limited for several weeks and grip strength will take about two months to recover.
Recovery After Treatment
Mild pain will persist for six months, and it may take up to year before you note complete recovery. There is about a 10% rate of recurrence of carpal tunnel syndrome even with surgical treatment.
Like all surgical procedures there are risks of infection, injury to nerves and tendons, and failure to completely relieve all the symptoms. Most scientific studies indicate a better than 90% patient satisfaction rate with carpal tunnel surgery.
Seeking Help from a Physician
The best way to know if you, or someone you know, has carpal tunnel syndrome is to see a physician who can make the diagnosis. Request an appointment with The Bone and Joint Center of Yuma to get the care you need.