Carpal tunnel syndrome is a condition that can cause numbness and tingling in the tips of your thumbs, index fingers, middle fingers and part of your ring fingers.
Carpal tunnel syndrome occurs when the median nerve, which is a major nerve that runs from your neck to the palm of your hands, gets compressed at an internal passageway at the base of your wrist known as the carpal tunnel.
When you snag a fingernail or touch a hot burner, nerve signals travel through the median nerve to tell you, for example, “That hurts!” or “That’s hot.” With carpal tunnel syndrome, however, your thumbs, index fingers, middle fingers and part of your ring finger don’t get the message like they should because swollen tendons and tissue at the carpal tunnel are squeezing the median nerve, creating a kind of nerve signal traffic jam.
In severe cases of carpal tunnel syndrome, you can lose feeling as well as strength in your fingers, sometimes to the point of being unable to use them. When you lose the use of your fingers, the simplest tasks, such as turning a doorknob or typing on a keyboard can become impossible.
Anything that squeezes the median nerve in the carpal tunnel space can cause carpal tunnel syndrome, including repetitive hand and wrist movements related to your job, whether you work at a desk or on an assembly line. Poor wrist position—having your wrists flexed when you’re typing on a keyboard rather than in a flat, neutral position can increase the pressure on the median nerve.
Health conditions, such as diabetes, thyroid problems, obesity, rheumatoid or psoriatic arthritis are also linked to carpal tunnel syndrome. The hormonal changes of pregnancy can also temporarily lead to carpal tunnel syndrome, which typically goes away after your baby is born. Your genes can also play a part. Some people’s carpal tunnel is just naturally smaller, which can increase the risk of the condition.
When you come into the Orthopedic Institute of New Jersey (OINJ) office, your hand doctor will ask questions about your medical history. You will also undergo a physical exam.
Unless there’s a clear indication your problem is coming from the carpal tunnel, your OINJ hand doctor may recommend a diagnostic corticosteroid injection to confirm the diagnosis. If the injection relieves pain, it’s a strong signal that nerve compression is occurring at carpal tunnel. If the injection doesn’t relieve pain, the median nerve may be compressed in your neck area or elbow.
Your hand doctor may also order electrophysiological tests as well as imaging studies, including ultrasound or X-rays, to determine if your median nerve is compressed or if something else may be causing the problem.
If carpal tunnel syndrome is caught early, nonsurgical treatment, including controlling an underlying medical condition, such as diabetes, anti-inflammatory medication, changing your daily habits to reduce the pressure on your median nerve, steroid injections, and wearing a night wrist brace or splint, may be all that’s needed.
If those treatments don’t relieve symptoms after several months, your orthopedic hand specialist may recommend surgery to relieve the pressure on the median nerve, which is a surgical technique known as carpal tunnel release.