Neurology Insights

Carpal Tunnel Syndrome: A Guide to Symptoms & Solutions

Do you have aching pain, numbness, and tingling on your wrist and fingers that won’t go away? Do you have to shake your hand in the morning to wake it up? It just might be Carpal Tunnel Syndrome.

Each year, over 3 million Americans are diagnosed with this neurological disorder that affects hand and wrist mobility.

What is Carpal Tunnel Syndrome & How Does it Develop?

Carpel tunnel syndrome (CTS), also known as nerve entrapment disorder, is a neurological disorder in which the median nerve (a major sensory and motor nerve that runs from the forearm through the wrist and into the palm and fingers) becomes compressed, resulting in inflammation, pain, and motor dysfunction. There is a ligament that can trap the nerve, forming a type of tunnel, which is where it gets its name.

When there is pressure on the median nerve over an extended period, surrounding cartilage and tissues swell, further constricting the nerve and producing a variety of symptoms, including numbness, tingling, loss of manual dexterity, as well as hand and wrist pain.

Like many neurological conditions, carpal tunnel is a disorder that worsens over time. This disorder often presents itself in patients through one of three stages: mild, moderate, and severe. Many individuals who develop carpel tunnel often become aware of their condition once the pain is acute, reoccurring, and has increased in severity.

Could I be experiencing Carpal Tunnel Syndrome?

When experiencing early signs of carpal tunnel, it is important to keep track of symptoms and seek a proper diagnosis immediately. Neglecting symptoms could lead to the degradation of surrounding muscle tissues and the progression of carpal tunnel syndrome from stage 1 to stage 2 and beyond.

“I always tell my patients the more tissue and nerve damage occurs, the longer the healing process is delayed, and the less complete the recovery will be.”

Early Signs & Symptoms of Carpal Tunnel Syndrome

When evaluating personal symptoms, paying attention to the time symptoms occur and worsen is always helpful. Do symptoms present and worsen at night? Is it after a long day of work? Is it after repetitive or mechanical activities like using power tools or holding a steering wheel?

Contact your neurologist if you are experiencing the following symptoms:

  • A recurring dull ache on the hand or wrist
  • Sudden numbness of the digits (thumb, index, middle, or the “thumb-side” of the ring finger)
  • Sharp needle-like pains located throughout the fingers
  • Frequent tingling of the wrist, digits, or palm
  • Change in motor skills (i.e., difficulty grasping objects, pain when performing tasks such as buttoning a shirt, using a zipper, etc.)
  • Ongoing pain at the site of wrist and hands
  • Worsening symptoms at night or early morning

Common Causes of Carpal Tunnel Syndrome

While we still do not know the exact cause of carpal tunnel, the risk of developing carpal tunnel syndrome most commonly coincides with the following conditions:

  • Individuals 50-84 years of age
  • Diabetes (type 1 & 2)
  • Rheumatoid arthritis
  • Individuals with a profession that requires repetitive activity involving the hands and wrist (assembly line worker, cashier, hairdresser, musician, clerical worker, etc.)
  • Obesity
  • Pregnancy
  • Menopause

Is There a Cure for Carpal Tunnel Syndrome?

Thankfully, many options and treatments exist for patients suffering from carpal tunnel syndrome. Diagnosis can be performed through physical examination, MRI, ultrasound, electromyography, and nerve conduction studies.

It is important to undergo a proper examination to get an accurate diagnosis and rule out other possibilities.

Once your neurologist has made a proper diagnosis, one or more of the following treatment options may be advised:

  • Physical Therapy: Supportive stretches and exercises for mild to moderate conditions
  • Behavior Modification: Introducing the use of supportive tools to prevent compression of the wrist, such as a mouse, daytime wrist support for typing, and more.
  • Wrist Splinting: A brace worn at night to ease discomfort
  • Steroid injections: Corticosteroids can reduce inflammation and offer pain relief. Treatment lasts between 6 weeks to 6 months
  • Surgery: Surgical options are a beneficial, lasting solution for patients who don’t respond to non-invasive treatments. Open or Endoscopic surgery may be performed to open the carpal tunnel to release pressure from the median nerve. Medications, including anti-inflammatories and even oral steroids, may be beneficial.

A message from Dr. Kandel

“Carpal tunnel is an easily treated problem if you address it in time. Ignoring the problem only leads to more pain, numbness, and weakness, and it may actually lead to permanent damage. If surgery is ultimately necessary, recovery can be as short as one week with no lasting limitations.

Don’t ignore your symptoms! Finding out about the problem, with a correct diagnosis and appropriate therapeutic intervention, can lead to complete recovery from carpal tunnel syndrome.”

Dr. Joseph Kandel portrait

Joseph Kandel, MD

Board Certified Neurologist
Serving Naples and Fort Myers, FL

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