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Finding Light at the End of the Carpal Tunnel

Odds are, when you hear the term “carpal tunnel syndrome (CTS),” the first image that springs to mind is an office worker sitting behind a desk, hunched over a computer, and rubbing their hands together in apparent pain. For many years, it was common thought that repetitive motions like clicking a mouse and typing on a keyboard would directly cause the distinctive numbness and tingling of this common nerve condition. However, as Southeastern Med orthopedic surgeon Dr. Vanessa Falk explains, this theory has largely been disproven.

“Repetitive activity can certainly make the symptoms worse,” she says, “but carpal tunnel syndrome is specifically caused by a compression of the median nerve at the wrist, and that can occur as a result of any swelling that pushes on the nerve that runs within a ‘tunnel’ in the wrist location. The swelling could be from an injury, fractures, pregnancy, a thickening of the ligament that makes the roof of the tunnel, or it can be from an unknown cause.”

In other words, it’s not just typists and assembly line workers who are vulnerable to carpal tunnel, although they might be likely to face more severe symptoms. Another misconception is that carpal tunnel involves a consistent ongoing discomfort, when in fact, pain can subside and return depending on what activity you’re doing or the time of day. This begs the question; since many of us experience various forms of hand and wrist pain, especially as we get older, how can we know if it’s a mild temporary issue or carpal tunnel?

“Carpal tunnel syndrome is defined as numbness and tingling in the thumb, index, middle and part of the ring finger,” Dr. Falk says. “The small finger is unaffected. The numbness and tingling can be reduced with rest and shaking the wrist to ‘wake the fingers back up,’ but carpal tunnel itself typically doesn’t go completely away; it will usually return when you’re doing a specific motion or action, or at nighttime if that’s the established pattern. By comparison, a normal strain or sprain to the wrist will gradually improve with rest, anti-inflammatories, and ice, and you are usually back to normal in a few weeks.”

If you’ve over 30 and have already been diagnosed with diabetes, high blood pressure, or arthritis, your odds of getting CTS also increase. Women, additionally, are more likely to have the condition than men.

Because we tend to think of carpal tunnel as an almost unavoidable side effect of hard work, we don’t always think about the idea of seeking treatment for it. In fact, if your physician determines that you do have the condition, there are solutions available to reduce the symptoms. In other words, there may be a light at the end of this tunnel!

According to Dr. Falk, “for milder cases of carpal tunnel syndrome, cortisone injections to decrease the swelling inside the ‘tunnel’ may be an option. Another helpful resource is over-the-counter wrist splints that keep the wrist straight at night so the nerve isn’t compressed as we sleep. Anti-inflammatories can also sometimes be helpful for milder symptoms.”

If you suffer with a more extreme version of CTS, treatment can be done locally at Southeastern Med.

“If the pain, numbness, or tingling are persistent enough to keep you up at night, or if your grip strength is impeded enough that you can’t perform your job or daily tasks, it’s definitely time to get medical attention,” Dr. Falk says. “An Electromyography and Nerve Conduction Test, EMG/NCT, can help determine the severity of the nerve compression. If the nerve is seeing significant compression, and there is muscle loss or decreased function, surgery to release the pressure from the nerve may be required.”

To learn more about carpal tunnel syndrome or to set up an appointment to discuss your symptoms, contact one of the physicians on our Orthopedics team.

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