Diagnosing Carpal Tunnel Syndrome
Kraig Burgess, MD, is a board-certified orthopedic hand and upper extremity surgeon at Banner Estrella Medical Center.
Question: I have lately felt shooting pains and a tingling sensation in my right arm and hand when working my mouse or typing on my keyboard and my hands “go numb” frequently. Do you think I have carpal tunnel syndrome?
Answer: Carpal tunnel syndrome is difficult to diagnose without a physical examination of the hands, arms, shoulders and neck; therefore, my first suggestion would be to consult your physician immediately if you are having regular pain, weakness or numbness in your hand, wrist or forearm.
If your pain is found to be a result of carpal tunnel syndrome, early diagnosis and treatment are important to avoid permanent damage. The condition can be progressive and is caused by the compression of the median nerve, which controls sensation and muscle control to the hand, fingers and thumb. Carpal tunnel syndrome gets its name from the rigid passageway of bones and ligament at the base of the hand – the tunnel, which surrounds the median nerve.
Initial treatment generally involves resting the affected hand and wrist, avoiding activities that may worsen symptoms and immobilizing the wrist in a splint to avoid further compression on the nerve.
In special circumstances, various medications such as anti-inflammatories may ease symptoms that have been present for a short time or have been caused by strenuous activity. Stretching and strengthening exercises, as well as corticosteroid injections, can also be helpful in certain patient populations. If surgery is required, carpal tunnel release involves releasing the thick ligament through a small incision to reduce pressure on the median nerve. Surgery is often done under a form of local anesthesia and does not require an overnight hospital stay. Although symptoms may be relieved immediately after surgery, full return of normal sensation and strength from carpal tunnel surgery can take months. Some patients with less strenuous work duties return to work after only one to two weeks, while others who place heavier demands on their hands may require three to four weeks for a full return to work.
While many “cubicle dwellers” complain of the syndrome, it is more typically found in assembly line workers. There is little clinical data to prove whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome. Not all carpal tunnel syndrome is work and motion related. Certain medical conditions such as diabetes and thyroid disease can increase your risk. This syndrome is also more common in women than men and occurs with greater regularity in people over 50 years of age.