What Do I Need to Know About Carpal Tunnel Syndrome?

It can cause pain, numbness and tingling in your fingers and hands. Find out who’s at risk and how it’s treated.

Chances are, you’ve heard of carpal tunnel syndrome, a common disorder that affects almost 2 million people in the United States. But do you know who’s more likely to develop it or how it’s treated? Read on to learn more.

Carpal tunnel anatomy

One of the major nerves to the hand, the median nerve, runs from your forearm through a narrow passage in your wrist called the carpal tunnel, then down into the palm of your hand. The nerve provides feeling to all of your fingers except your little finger and controls some muscles at the base of your thumb. When the nerve becomes pressed or squeezed at the wrist, you may start to experience numbness, weakness or pain in the hand, wrist, forearm and arm. You might even drop things due to a decrease in grip strength.

Risk factors

Carpal tunnel syndrome is caused by a variety of factors. Women are three times more likely than men to develop carpal tunnel syndrome, and people in certain occupations, such as assembly-line work, may be more prone to it.

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People with diabetes, rheumatoid arthritis and thyroid disease are also at risk.

“Research has shown that people with diabetes are up to four to six times more likely to have carpal tunnel syndrome,” says Rachel Lefebvre, MD, an orthopaedic hand surgeon at Keck Medicine of USC and assistant professor of clinical orthopaedic surgery at the Keck School of Medicine of USC.

How it’s treated

Once you’ve been diagnosed with carpal tunnel syndrome, your doctor may suggest a nonsurgical or surgical treatment plan.

Nonsurgical treatments can include:

  • Wearing a brace or splint at night to prevent your wrist from bending while you sleep
  • Over-the-counter medications to alleviate pain
  • Steroid injections to calm symptom flare-ups
  • Avoiding activities that exacerbate symptoms
  • Yoga to reduce pain and increase grip strength

“For some patients, a splint worn at night can be the initial, and sometimes only, treatment,” Dr. Lefebvre says. “For other patients, surgery is recommended right away. This all depends on the severity of the condition and how significant the nerve compression is.”

Carpal tunnel surgery is a same-day procedure that involves cutting the carpal ligament that is causing pressure on the median nerve. This is like taking the roof off a building where the people are too tall inside, Dr. Lefebvre explains: It creates room for the contents of the carpal tunnel to expand out the top and stop being compressed.

“Some surgeons use very small incisions and a camera to look inside the wrist,” Dr. Lefebvre says. “Others use a larger incision and directly look at all the structures. The most important part of the surgery — however it’s done — is to make sure the tight ligament is completely released.”

For some people, their hands will feel completely normal after surgery. Other people may have some symptom improvement, while some will have no improvement at all.

“It’s important to know that if your numbness is constant before the surgery, it often does not completely resolve after having carpal tunnel release,” Dr. Lefebvre says. “If you have constant numbness or severe carpal tunnel syndrome, surgery can still be a good idea — to stop the progression of the disease.”

by Heidi Tyline King

Do you think you might have carpal tunnel syndrome? The experts at the USC Hand Center can help. If you are in the Los Angeles area, schedule an appointment or call (800) USC-CARE (800-872-2273).