Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common condition, which often arises from repetitive use and overuse of the hands. It occurs in both men and women, across many age ranges. Carpal tunnel syndrome is a problem of nerve irritation in the wrist, or carpus.
Do your hands fall asleep? Do they get numb of tingly, or have the sensation of pins and needles? Is there cramping or aching in the wrists or palms that wakes you up at night? Do your hands feel clumsy or do you feel that you are losing your grip strength? These may be symptoms of carpal tunnel syndrome.
In carpal tunnel syndrome, the major nerve in the wrist, the median nerve, travels through a narrow passage called the carpal tunnel. On three sides of this tunnel, the border is comprised of bone. On the fourth side, just underneath the palmar skin, there is a very tough piece of connective tissue called the transverse carpal ligament. This ligament might as well be bone, as it stretches very little. Through this carpal tunnel travel the nine tendons which allow you to make a fist with your fingers, and the median nerve. Repetitive work or traumatic injury can cause swelling of the tendons in the tunnel, thereby compressing the nerve. The nerve becomes irritated, and patients frequently complain of numbness, tingling, and/or pain in the hands or wrists.
Characteristically, in carpal tunnel syndrome patients report that symptoms are made worse with use of the hands, such as writing, typing, driving a car, washing your hair, or talking on a telephone. Many patients also have trouble sleeping, as the symptoms may wake them up out of sleep at night. Patients frequently report that they have to shake their hands out to restore bloodflow or sensation to their hands and fingers. While these symptoms may be annoying, if not treated, carpal tunnel syndrome can even cause permanent nerve damage to the hand and loss of hand function.
A spectrum of treatments is available for carpal tunnel syndrome. These include splinting, oral anti-inflammatory medications, ergonomic work and activity changes, and therapy. If these modalities don’t work, steroid injections and surgical decompression are available. At California Hand Center, all these methods are employed. But when conservative measures aren’t adequate, a minimally-invasive straight-forward surgical decompression provides the cure. This procedure can be done under regional anesthesia (just the arm is “asleep” for the surgery), in a day surgery setting.
The staff of California Hand Center has performed more than 1,500 minimally-invasive carpal tunnel releases over the last decade. This unique technique does not require general anesthesia, and enables patients to use their hand immediately. Most people are able to return to routine activities within 1-2 weeks. We pride ourselves to be among a very few centers nationally with such an experience and expertise in minimally-invasive carpal tunnel release.