Carpal tunnel syndrome causes pain, tingling and numbness in the hands, wrists and arm that will wake up the soundest of sleepers in the middle of the night. They might find relief running hot water over their wrists or taking an anti-inflammatory medication, but most likely the pain will come back in the morning. So what exactly is carpal tunnel syndrome and is there anything you can do to tackle it for good?
The carpal tunnel is a narrow passageway comprised of bones, ligaments and tendons at the base of the hand beneath the palm. Carpal tunnel syndrome is caused when the median nerve – which runs from the forearm down through the hand – becomes compressed in the carpal tunnel area.
Dr. Brad Meland, a hand, wrist, and nerve surgeon at Altru Advanced Orthopedics says the culprit is a ligament at the base of the hand that becomes too tight.
“Basically, that cuts off the blood supply and will slowly kill the nerve fibers in the area,” he says. “That’s what causes the pain and numbness.”
Dr. Meland says a number of things cause the ligament to press down on the nerve. Some people are just born with a narrow carpal tunnel, others experience swelling in the area from pregnancy, arthritis, injury or other factors. Sometimes work is to blame.
“We see a lot of dental hygienists or people who work with computers. Anyone who holds their wrists in a flexed position for a long period of time is at risk of developing carpal tunnel syndrome,” he says.
But Dr. Meland says no occupation is immune. Carpal tunnel syndrome happens to both men and women, young and old, construction workers and hairdressers. According to the American College of Rheumatology, carpal tunnel syndrome is one of the most common nerve disorders affecting between four to 10 million Americans.
Dr. Meland encourages people to see their primary care doctor soon after symptoms start because mild to moderate carpal tunnel syndrome can be reversed if it’s caught soon enough.
Travis MacKenzie, a certified hand therapist for Altru Health System, says he always starts with a conservative approach, including education and ergonomic assessments.
“We talk a lot about posture. Sometimes exercise can improve posture at your desk and that could help relieve symptoms,” MacKenzie says.
For some, he might recommend wearing a splint to keep the wrist in a neutral position, while for others creating a plan of nerve and tendon gliding exercises will relieve tension on the nerve and help it better glide through the carpal tunnel. Other treatments include ultrasound, iontophoresis and deep tissue massage. But MacKenzie says time is of the essence.
“The longer the symptoms have gone on, the less successful these treatments are likely to be,” he says.
If that’s the case, Dr. Meland will step in to perform surgery.
“I do around 10 to 12 (surgeries) a week on average. Many people elect to have surgery because they simply can’t handle the pain anymore,” he says.
Dr. Meland performs the carpal tunnel surgery by making two small incisions and cutting the ligament to relieve the pressure. After the ligament is cut, the pressure on the nerves goes away and the nerves repair themselves. The patient is awake the whole time and the procedure takes about 30 minutes. He says his patients are using their hands again the next day and require little time away from work.
Both Dr. Meland and MacKenzie say there are plenty of weapons in the fight against carpal tunnel pain.
“It’s nothing you have to live with,” MacKenzie says “There are treatments that can and will eliminate the symptoms.”