Carpal Tunnel Syndrome

Causes and Symptoms of Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by increased pressure on the median nerve. This can occur when there is acute or chronic inflammation of the structures in and around the carpal tunnel.

Some conditions or factors that can contribute to carpal tunnel syndrome include:

• Obesity
• Diabetes
• Rheumatologic conditions
• Thyroid disease
• Pregnancy
• Repetitive hand/wrist activities, especially in awkward positions
• Certain prolonged awkward positions
• Repetitive, forceful gripping
• Flexor tenosynovitis / tendonitis
• Wrist fractures or dislocations
• Wrist arthritis
• Herniated disc in the neck

Common symptoms of carpal tunnel syndrome include:

• Numbness
• Tingling
• Pain in the wrist that radiates into the palm, fingers, and forearm (usually worse at night)
• Weakness that leads to dropping things
• A feeling of fullness or swelling in the hands and fingers

While symptoms usually start gradually, they can progress and become constant if left untreated.

Diagnosis and Treatment

In most cases, an initial diagnosis of carpal tunnel syndrome can be made based on reported symptoms and a physical exam. The diagnosis can then be confirmed using an ultrasound, which is done in-office. A nerve conduction test and/or MRI may also be ordered. While X-rays do not directly confirm the diagnosis, they can show bone or joint problems that may be contributing to the condition.

Once diagnosed, Dr. Kinchelow has two main goals for treatment: alleviate your symptoms and prevent ongoing pressure and worsening of the condition. In some cases, prolonged and/or severe compression on the median nerve may result permanent damage.

Initial treatment options may include:

• Wrist splints (at bedtime and as needed during the day)
• Anti-inflammatory medication
• Stretching exercises (and possibly formal therapy)
• Photobiomodulation (laser) therapy
• Steroid injection (or a short course of oral steroids)

Generally, these treatment options are more effective when the condition is recent in onset and with mild, intermittent symptoms. However, when the condition progresses and becomes chronic and/or moderate to severe, these treatments may only provide temporary relief. At this stage, a procedure is necessary to release the pressure on the nerve more reliably.

Minimally Invasive Office Procedure for Carpal Tunnel Syndrome

A minimally invasive office procedure can be an effective route to treat CTS. This mild procedure, performed under local anesthesia, is designed to relieve pressure on the median nerve. No pre-op testing, general anesthesia, or systemic sedation is needed, making it a convenient and safe option for most patients.

During the procedure, Dr. Kinchelow creates a small incision on your wrist to cut the carpal ligament and make the carpal tunnel larger. The incision is then closed with Steri strips, removing the need for sutures.

Patients typically return to their daily activities within 3-7 days following the procedure, with a gradual return to repetitive and/or forceful gripping activities. Anti-inflammatory medication (like ibuprofen or naproxen) and Tylenol can be used to sufficiently help with post-procedure pain.

Finger, hand, and wrist motion is started right away, and most patients do not need formal occupational or physical therapy.