Am Fam Physician. 2003;68(2):279-280
What is carpal tunnel syndrome?
Carpal tunnel syndrome is caused by pressure on the median nerve. This is a nerve that goes through your wrist (see the picture below). The median nerve can become pinched at the carpal tunnel, which is a small canal, or space, near the base of the palm of your hand. In this picture, an inflamed ligament is pressing on the median nerve. The arrow shows the place where the ligament presses the nerve.
What are some symptoms of carpal tunnel syndrome?
If you have carpal tunnel syndrome, some or all of your fingers may feel numb. You may have a “pins and needles” feeling in your hand, as if your hand is asleep. Your hand may hurt. You may have pain or a burning or prickling feeling in your arm. You may drop things. Sometimes you may feel something like “electrical shocks” from the center of your wrist into your hand.
Your symptoms are likely to be worse at night. They also may be worse when you bend your wrist while you read the newspaper, drive your car, or work at a computer keyboard.
Hanging your hand down or shaking your wrist may make your hand feel better for a while.
How does my doctor know that I have carpal tunnel syndrome?
Your doctor may be able to tell that you have carpal tunnel syndrome by examining your hand and asking you about your symptoms. You also might need to have a special test, such as a nerve conduction study. This test will show how well your median nerve is working.
How is carpal tunnel syndrome treated?
It may help to wear a special splint that keeps your wrist in a neutral position while you sleep. You also might choose to wear the splint during the day. Exercises to stretch the carpal tunnel may help.
Your doctor might have you take a steroid medicine in pill form. A steroid injection (a shot) in or near the carpal tunnel might help your hand feel better for a longer time.
If your symptoms bother you a lot or do not get better after two steroid injections, you might need carpal tunnel release surgery.
What is carpal tunnel release surgery?
During carpal tunnel release surgery, the surgeon cuts the band that forms the top part of the carpal tunnel. This takes some pressure away from the median nerve.
Carpal tunnel release surgery can be done through a cut in the palm of your hand. It also can be done with small instruments that are put into your wrist.
You will need to wear a wrist splint for several weeks after this surgery.