Carpal tunnel syndrome is one of the costliest medical conditions to treat. In the United States, care for it costs more than $2 billion per year. Then, when you figure in indirect costs like lost wages and lost work days, it’s even more expensive.
Luckily, there are a number of treatments available for carpal tunnel syndrome—including some at-home treatments—as well as ways to prevent the condition from starting in the first place. But, before you can attempt to treat or prevent carpal tunnel syndrome, it’s helpful to know what’s going on in your wrists.
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a nerve compression syndrome, where the median nerve is being pinched. It controls movement and sensation of the palm, thumb, forefinger, middle finger and part of the ring finger. Nerve roots that eventually become the median nerve start in the neck and upper back and the nerve travels down the arm and run all the way down to the fingertips.
This nerve passes through the carpal tunnel, a hollow space between finger bones (carpal bones) and the ligament that connects them. The median nerve and the tendons attached to the muscles that allow the fingers to flex (flexor tendons) run through this narrow space.
Carpal tunnel syndrome occurs when the carpal tunnel narrows and something presses on the median nerve. Sometimes the flexor tendons swell and become inflamed, often through overuse. Other times, certain chronic conditions can cause the space to narrow.
Carpal Tunnel Treatment
Carpal tunnel syndrome is painful and can cause tingling and numbness in the hand and fingers. If left untreated, it may even cause irreversible muscle degeneration. That’s why it’s so important to seek treatment at the first sign of symptoms. Often, that first sign is waking up to pain or numbness in the hand or wrist, since most people are not conscious of the way they hold their wrists when they sleep.
Thankfully, there are a number of treatments for carpal tunnel syndrome—surgical options as well as nonsurgical lifestyle modifications. For example, if you find yourself waking up with painful, numb or tingling palms or fingers, invest in a wrist splint to wear while sleeping.
My colleagues and I generally recommend the minimum effective dose—that is to say, the least amount of intervention required to manage a problem or condition. That’s why our first recommendation is often over-the-counter (OTC) anti-inflammatory medicines like ibuprofen.
Because inflammation is to blame for many cases of carpal tunnel syndrome—including rheumatoid arthritis, gout and the swelling of flexor tendons—anti-inflammatories can decrease the swelling and eliminate the pressure on the median nerve that is causing symptoms. If OTC medicines don’t help, corticosteroid injections may. Steroids are powerful anti-inflammatory medications and can be injected directly into the affected tissue to reduce inflammation and pain.
If splinting and anti-inflammatories do not help alleviate symptoms of carpal tunnel syndrome, there are surgical options, including carpal tunnel release. This surgery involves cutting the transverse carpal ligament that forms the “roof” of the carpal tunnel. This will give the tissue inside the tunnel more room instead of crowding the median nerve.
Preventing Carpal Tunnel Syndrome
Just because you work a desk job, or operate power tools for a living, or have a job function that requires repetitive hand movement, doesn’t mean you’ll get carpal tunnel syndrome. You can follow these tips to reduce your risk. As a bonus, if you do have symptoms of carpal tunnel syndrome, these tips may help stop them before they progress:
- Avoid flexing or rotating your wrists too often
- Avoid grasping anything too tightly
- Avoid sleeping on your hands
- Keep your wrists straight while typing or using tools
- Perform wrist exercises and stretches that strengthen and increase range of motion in all directions
- Take frequent breaks when performing repetitive tasks with your hands
As a child, I suffered a fracture in my arm that led to a diagnosis of a benign bone tumor. That’s why I’m so passionate about orthopedics and especially caring for the upper extremities. If you are living with carpal tunnel syndrome—or any condition of the hand, wrist, elbow or shoulder—request an appointment with me and I’ll be happy to discuss your options and come up with a treatment plan that works for you and your situation.