What is carpal tunnel syndrome?
Carpal tunnel syndrome is caused by pressure on the median nerve of the wrist. This compression or pressure causes you to feel pain, numbness and tingling in all fingers. You’re likely to feel these symptoms when gripping something or when you first wake up.
The Ohio State University Wexner Medical Center in Columbus, Ohio, is home to orthopedic hand specialists who can provide the proper treatment to ease your symptoms and decrease the risk of long-term nerve damage. Our hand experts will help return you to regular, less painful activity.
What causes carpal tunnel syndrome?
Carpal tunnel is often associated with those who work in jobs where the hand experiences constant vibration, repetitive wrist flexing or long periods of driving with the wrist on the steering wheel. Carpal tunnel syndrome may be the reason for numbness or tingling in your hand while driving. Women are more likely than men to develop carpal tunnel syndrome.
Additionally, there are many other causes of carpal tunnel syndrome or risk factors of developing it, including:
- Injury to your upper extremity, such as a broken wrist (distal radius fracture)
- Certain medical conditions such as arthritis, rheumatoid arthritis, diabetes, hypothyroidism, ganglion cysts
- Those who have alcohol use disorder or smoke
- Obesity
- Pregnancy and menopause
Can you prevent carpal tunnel syndrome?
There is no certain way to prevent carpal tunnel syndrome. However, you may decrease your risk by easing the strain on your hand or wrist muscles, such as by relaxing your grip, taking frequent breaks from using hand and wrist muscles, not bending your wrist significantly when using a keyboard and by improving your posture and keeping your hands warm.
Carpal tunnel: common misconceptions
Hisham Awan, MD, explains the contributing causes of carpal tunnel syndrome and how Ohio State can get you back to regular activity quickly.
Carpal tunnel syndrome symptoms
Most symptoms begin gradually, then become more noticeable over time. The most prominent symptoms are tingling, numbness and weakness. You may feel a strong need to shake out your hand.
Tingling and numbness in fingers
Those who have carpal tunnel syndrome experience numbness and tingling in fingers or the entire hand. You’ll notice these sensations usually in the thumb, index, middle and ring fingers. It is not always felt in the little finger. Symptoms appear when gripping something, such as a steering wheel or cell phone, or when you first wake up in the morning.
The tingling can travel from your wrist up through your arm. At first, you may only have the sensation occasionally, but over time the numbness may become more constant.
Weakness
You may be experiencing a weak grip strength, which may seem more like clumsiness or accidentally dropping items. This weakness is due to numbness or a weakening of your thumb’s pinching muscles. You may find it difficult to pinch your thumb and fingers together.
Diagnosis of carpal tunnel syndrome
When you experience symptoms daily and they become bothersome, it’s time to see a doctor. You should also see a doctor if you notice weakness in your hand that you otherwise can't explain. The diagnostic process for carpal tunnel syndrome begins with a thorough medical history and physical exam, and possibly an X-ray of the hand or wrist. Your provider may order a nerve conduction study and an electromyogram (EMG) to check for other nerve problems.
Treatment for carpal tunnel syndrome
Early and proper treatment of carpal tunnel syndrome can ease your pain and decrease the risk of permanent nerve or muscle damage. Depending on the stage and severity of your condition, our team can recommend at-home, nonsurgical or surgical treatment options.
At-home treatment
In very early stages of the condition, you may be able to ease symptoms by resting your hand muscles more frequently and icing your hand to reduce swelling.
If you have any numbness in your hand, you should see a hand expert at the Ohio State Wexner Medical Center.
Nonsurgical treatment
If you have carpal tunnel syndrome, your doctor can recommend several nonsurgical treatment options, including:
- Nonsteroidal anti-inflammatory medication (NSAID) to relieve pain
- Wearing splints on your hand or wrist at night – The splint holds your wrist still while you sleep and can help relieve symptoms of tingling and numbness. Even though the splint is only worn at night, you may also see improved symptoms during the daytime.
- Steroid injections – Your doctor may inject the carpal tunnel with corticosteroid medicine to relieve pain and decrease swelling.
Carpal tunnel release surgery
If carpal tunnel release surgery is right for you, it will be done as an outpatient procedure, meaning you’ll go home the same day. Your hand surgeon will cut the ligament that crosses over the carpal tunnel to lessen pressure on the median nerve. Current research shows positive results for carpal tunnel release surgery, with a success rate between 90 and 95%.
Surgery may not ease all your symptoms, as everyone heals differently and the severity of your condition may vary. While you will be able to work and drive right after surgery, it may take three to four months to gain full strength and normal use of the hand after surgery. You should always allow your body time to rest after surgery and avoid heavy activity as much as possible. For those with severe compression causing carpal tunnel syndrome, complete recovery can take up to a year.
Why choose Ohio State for treatment of carpal tunnel syndrome?
When treating your carpal tunnel syndrome, our goal is to try other solutions before considering surgery. If your carpal tunnel is severe and we feel surgery is the best option, the Ohio State Hand Center provides many different techniques, performed with expert care by hand surgeons who have extensive training. We offer either wide-awake local anesthesia or full sedation during your procedure. It is your choice what technique and which anesthetic type is best for you.
