Carpal tunnel syndrome is an extremely common condition that can cause pain, tingling, numbness and weakness in the hand and wrist. The belief that carpal tunnel syndrome only affects office workers or individuals who spend their days typing has been debunked.
"There are many potential causes of carpal tunnel syndrome, not just typing, as many patients mistakenly believe," explained Endeavor Health sports medicine specialist Shaheen Jadidi, DO.
The carpal tunnel in the wrist houses the median nerve as well as nine different tendons, all tightly enclosed by bones and ligaments.
What causes it?
Pressure on the nerve or damage inside the tunnel can result in the pain and numbness known as carpal tunnel syndrome. “It doesn’t take much to irritate the nerve — fluid retention, swings in weight, arthritis — can all contribute,” said Dr. Jadidi.
Pregnancy, obesity, diabetes, hypothyroidism, wrist fractures or a history of trauma to the wrist can also lead to carpal tunnel syndrome.
What are the symptoms?
It’s important to check with a physician if you experience pain, numbness/tingling or weakness in your hands or wrists, urged Dr. Jadidi. People often experience symptoms at night that wake them from sleep and may need to shake their hands out to bring feeling back, he said.
"If you notice you're dropping things frequently or the muscle at the base of your thumb seems to be shrinking, these could be more severe signs of carpal tunnel syndrome," warned Dr. Jadidi.
Why address it?
While carpal tunnel syndrome frequently responds well to conservative treatment, delaying treatment can cause irreversible nerve damage.
"If left untreated for too long, the median nerve can become severely impaired, leading to muscle weakness, and there is a chance that even surgery may not fully restore the lost strength," Dr. Jadidi explained.
“Once it starts affecting your strength, the muscles can atrophy and you are playing with fire if you ignore it,” he added. “That’s a hard conversation to have with patients.”
How is it treated?
Some ways to manage carpal tunnel syndrome include:
- Use a splint. The first step in conservative management is typically wrist splinting. An over-the-counter Velcro splint can be used to hold the nerve in a neutral position and let the nerve rest. “Ideally try to wear the splint as much as possible and at the very least you should sleep in it. The splint helps give the nerve some breathing room,” said Dr. Jadidi.
- Take anti-inflammatories and NSAIDs (non-steroidal anti-inflammatories).
- Modify or limit activities that strain the wrist.
- Pay attention to ergonomics. If you are working at a computer, keep your wrists in a neutral position, suggested Dr. Jadidi.
- Lose excess weight if obesity is a factor.
- Visit an occupational therapist. Those who specialize in hand and wrist treatments offer therapy in phases — first to reduce pain and inflammation, then to optimize range of motion, and finally to build up strength. Building muscular strength can help heal carpal tunnel syndrome as well as prevent it from recurring by keeping the wrist more stable.
- Consider surgery. When conservative methods are not enough, surgery can be the best option. “We have highly trained hand surgeons who can perform endoscopic carpal tunnel release surgery through a tiny incision that can even be hidden within the natural wrinkles of your wrist,” said Dr. Jadidi. Patients are often awake during the procedure and achieve excellent outcomes.
“The biggest takeaway when dealing with carpal tunnel syndrome is don’t wait too long to get treatment,” said Dr. Jadidi. “The earlier you treat it, the better the outcome.”
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