Image
You can feel it as pain in your hand, wrist or forearm. It also can make your hands numb or cause that awful pins and needles sensation. What you’re experiencing is likely carpal tunnel syndrome, one of the most common repetitive stress injuries.
The carpal tunnel is a small passageway found on the palm side of the wrist. When repeated stress triggers swelling in this area, it puts pressure on the nerves and tendons that run from the forearm into the hand, causing pain, numbness and tingling.
Risk factors
“Women are more likely to get carpal tunnel syndrome than men,” says orthopedic surgeon Karl Helmold, MD, with LVPG Orthopedics and Sports Medicine–Mauch Chunk Street in Pottsville. “And a significant percentage involves pregnancy (caused by fluid retention). Once the pregnancy ends, the symptoms of carpal tunnel syndrome usually go away.”
Diabetes and obesity also can cause carpal tunnel syndrome and addressing those health issues may eliminate the problem. However, carpal tunnel is most often associated with repeating motions such as working with hand-held power tools and playing racket sports, even computer keyboarding.
Treatments
“There are some nonsurgical treatments,” says orthopedic surgeon Ashkon Razavi, MD, with LVPG Orthopedics and Sports Medicine–1621 N. Cedar Crest. “Splinting, steroidal injections and acupuncture can relieve the inflammation. But if you continue the same repeated motions without moderation, correcting the problem often involves surgery.”
Sports medicine physician Stephen Evans, DO, with LVPG Orthopedics and Sports Medicine–Mauch Chunk Street in Pottsville, agrees that surgery is sometimes the best solution to relieve carpal tunnel syndrome.
“A lot of it is just the way you’re built,” Evans says. “The carpal tunnel is a confined area, and some people have thicker tendons than others. It may not require that much for inflammation to develop for that person, while another person can repeat the same motions over a lifetime and never develop any problems.”
The good news about surgery
“We will monitor a patient using nonsurgical treatments, but if the pain and/or numbness continues, surgery is generally indicated,” Helmold says. “Depending on the extent of the injury, we will recommend arthroscopic surgery or open surgery. The success rate for both surgeries is excellent, and following recovery there really isn’t any reason the patient can’t return to all normal activities.”
Razavi offers this analogy for what is accomplished with surgery.
“Imagine putting six people in a small car that only seats four,” Razavi says. “The people inside are getting squashed. With carpal tunnel syndrome, it’s the nerves and tendons inside the carpal tunnel that are getting compressed. The surgery essentially leads to reforming the car – the carpal tunnel – to make it bigger, removing the pressure.”
Generally, carpal tunnel isn’t likely to recur after the surgery.
“The chance is less than 2 percent.,” Helmold says. “The important thing to know is if you have pain or numbness in your hands, we are here to help you.”