Pain points: Is carpal tunnel release surgery right for me?

FARIBAULT, Minn. 8/31/2018 — Driving, reading a book or magazine, typing — suddenly, these once easy tasks have become much more difficult. As frustrating and nagging as the burning, tingling, itching or numbness in the hands and fingers becomes, carpal tunnel syndrome (CTS) is extremely common. In fact, CTS is one of the most common nerve disorders, affecting millions of Americans. 

What is carpal tunnel syndrome?

CTS happens when the ligaments that make up the carpal tunnel become swollen or irritated. Pressure on the nerve causes pain, numbness, tingling or weakness in the fingers and wrist. Many people will notice symptoms after doing certain activities such as driving, holding a book or those that require grasping something for long periods of time. The nerve affected in CTS is the median nerve which provides motor and sensory function to the hand.

What causes carpal tunnel syndrome?

There are a combination of factors that can cause CTS. Some factors include but are not limited to: 

• trauma or injury to the wrist that causes swelling
• overactive pituitary gland
• underactive thyroid gland
• rheumatoid arthritis
• mechanical problems in the wrist joint
• work stress
• repeated use of vibrating hand tools
• fluid retention during pregnancy or menopause
• development of a cyst or tumor in the canal.

“Carpal tunnel syndrome can affect people of any age but typically affects people who are exposed to repetitive motions with vibrations involved,” says Bryan Armitage, MD, Allina Health Orthopedic, Podiatry and Spine Clinic — Faribault. “Activities like cycling can aggravate the condition… symptoms typically start to become evident at night or in the morning after sleeping.”

Now what do you do?

First and foremost, you should take care of your hands and wrists. Some treatments include:

• Avoid activities that make the symptoms worse. Try taking frequent breaks from the tasks to rest the hand and wrist.
• Try splinting, especially at night to keep the wrist from bending.
• Practice alternative therapies like yoga to reduce the pain and improve grip strength.
• Consider over-the-counter pain medicine like ibuprofen and aspirin, as it may provide short-term relieve from discomfort.
• Consider prescription medicine to relieve pressure on the median nerve or injections of corticosteroid medicine to reduce the swelling.

“Carpal tunnel syndrome is typically progressive,” says Armitage. “Early stages with temporary numbness or periodic episodes can be managed conservatively with bracing or injections but when the condition becomes constant, surgery is typically required to relieve pressure on the nerve before permanent damage can occur.” 

Surgery for CTS is very common, successful and does not usually require a hospital stay. Patients are able to return home after a short recovery, typically the day of their surgery.

What happens after surgery?

Symptoms may be relieved immediately after surgery; however, full recovery of CTS may take a few weeks or months. While you’re recovering, a splint may be used to reduce wrist motion and activities should be modified. Recurrence of CTS following treatment is rare.

If you think you may be a candidate for carpal tunnel release surgery, talk to your doctor.

To learn more about orthopedic services including carpal tunnel syndrome, visit allinahealth.org/dohorthoclinic.

Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 10 hospitals / 13 campuses, 15 retail pharmacies, and many specialty care centers and specialty medical services, home care, and emergency medical transportation services.

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