Carpel tunnel syndrome is a very common condition, thought to affect up to 10 million Americans. It’s painful and can cause serious interference with day-to-day life.
A diagnosis of any painful health condition can be distressing, particularly one which interferes with functionality and sensation. Various conditions can cause similar symptoms, so it’s essential to get a diagnosis from a medical professional.
Anyone with this condition will be keen to find out as much as possible about carpal tunnel recovery. In the article below, we will outline the various treatment options available for carpal tunnel syndrome. Read on to find out more.
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome happens when the median nerve becomes compressed at the wrist. This is the nerve that passes from the forearm down to the palm.
The carpal tunnel is formed of ligament and bones, which work together to make a rigid passageway. This avenue holds the tendons that allow the fingers to bend, and also houses the median nerve. This nerve provides sensation to most of the fingers on the hand and also to the palm side of the thumb.
Carpal tunnel syndrome occurs when swollen tissue or irritated tendons cause the passageway to narrow. This compresses the median nerve and leads to weakness, numbness, and sometimes pain in the hand and wrist. Some sufferers also feel pain in the forearm and arm.
Risk Factors for Carpal Tunnel Syndrome
Carpal tunnel syndrome is more likely to develop in middle-aged and older people, while women are three times more likely to develop this condition than men. That may be because women’s wrist bones are smaller, which means the space through which the tendons and nerves must pass is narrower and more likely to become compressed.
Other risk factors include the hormonal changes women undergo during pregnancy and menopause. The build-up of fluid during pregnancy can cause pressure on the carpal tunnel. In menopausal women, the bone structure in the wrist can become enlarged and cause pressure on the nerves.
Other risk factors include genetic predisposition and injury or trauma. Sprains or fractures to the wrist can cause swelling or pressure to the nerve, which increases the risk of carpal tunnel syndrome developing.
The other well-known risk factor for carpal tunnel syndrome is repetitive wrist and hand movements. Occupational factors can be the cause of this. The condition is common in assembly-line workers, check out operators, and carpenters.
Certain hobbies, such as knitting and gardening, can also cause CPS to develop. Research is as yet limited as to whether long-term keyboard use is a risk factor.
Symptoms of Carpal Tunnel Syndrome
Most people affected by this condition report a gradual onset of symptoms. These can include:
- Numbness and tingling in the fingers
- A sensation of swelling in the fingers, even if no swelling is visible
- Pain in the hands, particularly at night
- A sense of needing to “shake out” the wrists and hands
- Hand weakness, making it challenging to undertake manual tasks or grasp small objects
In very severe cases where carpal tunnel syndrome goes undiagnosed for a long time, there may be muscle wastage in the thumbs. There have also been cases of patients losing the sensation of hot and cold in their hands and burning themselves without being aware of it.
It’s essential to seek medical advice if you notice any of these symptoms. There are other conditions with similar symptoms, such as arthritis and ligament damage. Also, other underlying conditions, such as diabetes, lupus, and hypothyroidism can make CPS worse. For these patients, in particular, expert medical input is essential.
How Is Carpal Tunnel Syndrome Diagnosed?
Early diagnosis and treatment are important, as if this condition goes untreated, it can lead to permanent nerve damage. Doctors usually undertake a physical examination of the hands and arms to rule out other conditions that are similar to carpal tunnel syndrome.
Wrists will be examined, and doctors will look for swelling, discoloration of the skin, and any sensation of heat. Each finger should also be examined, and the base of the hand also.
Your doctor might order diagnostic tests, including x-rays, to look for any fractures or arthritic damage. The medical team may also do blood tests to rule out any diseases such as diabetes, causing nerve damage.
Ultrasound imaging can also show whether the median nerve is of abnormal size. Occasionally an MRI scan may be ordered to show the anatomical structure of the wrist, but this is unusual and is not useful in diagnosing carpal tunnel syndrome.
7 Tips for Carpal Tunnel Recovery
Once diagnosed, you are likely to be keen to embark on a treatment program to lead to recovery from this painful and inconvenient condition. The treatment package offered by your doctor will depend on the duration and type of symptoms. Read on to learn more about the various options available for the treatment of this painful condition.
1. Wearing a Splint
Conservative treatment is almost always the first avenue that doctors will want to explore in your recovery from carpal tunnel syndrome. Wearing a splint or brace is often the first thing to try.
Splints in different sizes can be bought over-the-counter in drugstores. It’s important to find a splint which is rigid and aligns your wrists in a neutral position overnight. For daytime wear, a more flexible splint that allows a wider range of movement is a better option.
While splints can be worn 24 hours a day, many people initially only wear a splint at night. It keeps the wrist straight and reduces pressure on the median nerve. Often this is enough to reduce pain and other symptoms of numbness, tingling feelings, and weakness in the hands.
Splinting is most effective when commenced within three months of the onset of symptoms of carpal tunnel syndrome. That’s why it’s a good reason to ensure you seek medical advice as soon as you begin to identify any wrist problems.
2. Rest and Activity Modification
Rest is another first-line treatment, which is often recommended. If repetitive movement is the cause of the inflammation, often all that is needed is to stop or reduce this action.
Taking breaks from repetitive tasks is an easy step to take if the activity is recreational, although it may be more difficult if the tasks are required as part of the patient’s employment. Doctors may also recommend applying a cool pack to the wrist if it is swollen and red.
Symptoms are often worse at night. This can be improved by avoiding sleeping with any weight on your hands and trying not to bend your wrists.
3. Over-the-Counter Medication
Nonsteroidal anti-inflammatory drugs (NSAIDs) are often recommended for carpal tunnel recovery. These include ibuprofen and aspirin. While they are effective for pain relief and may provide short-term relief, it’s unclear whether they offer any long-term benefits.
4. Physical Therapy
A specialist physical therapist can recommend specific exercises to improve pain and increase strength in the wrist and hand. Even for people without symptoms, it’s a good idea to do hand exercises to prevent injuries.
A hand therapist might teach exercises that help keep the nerves and tendons gliding smoothly through the carpal tunnel. Some therapists also undertake therapeutic ultrasound, which can reduce pain, or administer steroids through the skin via a process called iontophoresis.
5. Cortisone Injections
Cortisone injections have been the main treatment modality for carpal tunnel syndrome for many years. Sometimes they are undertaken under endoscopic guidance. This is considered to be a safer treatment option than surgery.
Cortisone is an anti-inflammatory medication. But patients also usually experience a reduction in pain alongside reducing inflammation. Injections are generally most effective when the cause of the condition is temporary and likely to resolve. Cortisone injections are not as effective when the cause is anatomical or related to a chronic condition.
Treatment with cortisone injections can have some side effects. These should be considered alongside the risks and benefits. Elevated blood sugar and facial flushing are the most common systemic side effects which patients experience. There is also a small risk of infection and skin pigmentation changes.
6. Alternative Therapies
There is limited evidence that some alternative therapies may help pain relief and symptom control for carpal tunnel syndrome. One study from 1998 demonstrated that yoga was more effective than splinting or no treatment in relieving symptoms.
Some practitioners also support acupuncture and magnetic field therapy as alternative treatment options for carpal tunnel recovery. However, there is no conclusive evidence to demonstrate that these treatments have any effect.
For patients with severe carpal tunnel syndrome, or for whom other treatments have failed for at least six months, surgery is the next option that doctors will consider. Operations for carpal tunnel are some of the most common surgeries performed in the US.
The surgery involves severing a ligament around the wrist. This reduces pressure on the median nerve. The operation can usually be done under local or regional anesthetic. The majority of patients don’t need an overnight stay in the hospital.
Patients often undergo treatment on both hands. All carpal tunnel surgery involves severing the ligament, but there are two different methods commonly used by surgeons, so achieve this outcome and relieve pressure on the nerve.
Open release surgery is the traditional approach, which involves making an incision in the wrist and cutting the ligament to enlarge the carpal tunnel. This incision will be approximately 2 inches wide.
Keyhole or endoscopic surgery is another option, which is becoming increasingly popular. The incisions made are smaller, and the surgeon inserts a camera to guide a small knife inserted through a tube. The incision is made in the same way as in open release surgery but can result in less post-operative discomfort.
Carpal Tunnel Surgery Recovery
Most patients will likely have some symptom relief immediately following surgery. However, full recovery can take months. The majority of patients will experience some post-operative pain from incision sites. Regardless of whether the procedure was performed endoscopically or by open release this can be the case.
Some patients will experience infections, stiffness, nerve damage, and scar pain. It’s also very common for individuals to experience a reduction in grip strength. This usually improves over time.
Often people need to modify their daily activities, including their work, for several weeks following surgery. Some people may not be able to return to their previous jobs due to the risk of recurrence. It’s common for there to also be some residual sense of numbness or weakness in the hands following surgery.
How to Prevent Carpal Tunnel Syndrome
While recovery is possible, and for the vast majority of patients, carpal tunnel syndrome is treatable. It is better to prevent the condition from developing where possible.
Taking regular breaks allows the hands and wrists to recover and prevents swelling. Varying tasks to avoid long periods of repetitive movement is also a key preventative measure.
It’s a good idea to do regular hand and wrist stretching exercises, especially after a long period of time undertaking repetitive tasks. Bending and flexing your wrists in opposite directions is a good exercise to do. It’s also helpful to make a tight fist and hold it for a while, then release it and stretch out the fingers.
These exercises can cancel out the impact of a long period of repetitive movement. You should also try to keep your hands warm if your working environment is cold. Some people wear fingerless gloves to retain some warmth while still enabling dextrous movement.
Another important habit to break is the tendency to tense muscles and hold things with an unnecessarily tight grip. It takes some practice, but it’s good to avoid using a tight grip when working with hand-held devices, including pens and computer mouses.
How to Find a Carpal Tunnel Specialist
For some patients, conservative treatments just don’t work. In these instances, the next step will be to consider surgery for your carpal tunnel recovery. For the majority of patients, surgical treatment is possible. It can significantly improve dexterity and quality of life, as well as reducing pain.