Just Passing Pain? Or Carpal Tunnel Syndrome?

With carpal tunnel syndrome (CTS), your hand and wrist tingle or go numb from pressure on the median nerve that runs through a narrow passage from your forearm into your hand. This passage tends to be smaller in women than it is in men. “This may be one reason why women are three times more likely to develop CTS than men,” says orthopedic surgeon Daniel Torres, MD, with Lehigh Valley Orthopedic Institute.           

In addition to numbness, CTS may weaken, or cause pain in, your hand or wrist. Some people also have pain or tingling that travels down their arm. “Symptoms often start during the night but eventually can occur during the day, too,” Torres says.

CTS is usually caused by a number of factors that result in more total pressure on the median nerve and tendons in the carpal tunnel. CTS appears to be common in those performing assembly line work, such as manufacturing, sewing and meatpacking. “But CTS also can result from changing hormones and retaining fluid during pregnancy or menopause,” Torres says.

Other possible causes of CTS include:

• Wrist sprains or fractures
• Rheumatoid arthritis
• Obesity
• Diabetes
• Thyroid problems

Seeking treatment for CTS can help prevent permanent nerve damage. So if you suspect CTS, make time to see your primary care doctor or clinician.

Initial treatment typically involves resting your wrist in a splint, primarily at night. Keeping the wrist still and supported in a neutral position helps the nerves and tendons to heal. During the day, limit or avoid doing actions that aggravate CTS. “Cold packs, stretching and certain over-the-counter medicines may also help your symptoms,” Torres says. Your primary care doctor or clinician may suggest physical therapy to help strengthen your hand and wrist. If these measures don’t help, you may benefit from corticosteroids or other types of medicine – injected directly into your wrist or taken by mouth.           

When symptoms are severe or don’t respond to other treatments after at least six months, open carpal tunnel release surgery may offer relief. During this common outpatient procedure, local anesthesia is administered before a surgeon cuts the band of tissue around the wrist to reduce nerve pressure.           

Another surgical option is endoscopic surgery, which allows for smaller incisions. It offers the possibility of faster recovery and less discomfort than traditional open surgery.

Regardless of the treatment or type of surgery, specifically the type of surgery, prompt evaluation and treatment are most important in achieving relief of carpal tunnel symptoms. Often, delay in treatment results in permanent residual pain, numbness and weakness.