What is carpal tunnel syndrome?

 

Carpal Tunnel Syndrome (CTS) is a condition that causes pain in the wrist, numbness, tingling, in the first two ½ digits in the hand. CTS occurs when one of the nerves which is the median nerve gets pinched at the wrist where it travels through a small place. The median nerve is responsible for sensation and strength in the thumb, index finger, and second digit.

What are the symptoms of Carpal Tunnel Syndrome?

Common symptoms include pain in the wrist and hand, numbness and tingling in the thumb, index finger, and middle finger and become more pronounced with repetitive tasks like typing at the computer. Other symptoms include, shaking hands to try to stop the tingling, and pain in the middle of the night where patients sleep in unusual postures. When CTS becomes more severe, you can have weakness where you might report dropping objects.

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How can I prevent carpal tunnel syndrome?

Carpal tunnel syndrome can be prevented by making sure you have a neutral wrist posture when you are typing, taking adequate breaks, and avoiding having a flexed wrist consistently. Anytime you flex your wrist, it creates a more narrow space in the wrist where the median nerve can get compressed. Below is a picture of proper ergonomic posture.

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How is Carpal Tunnel Syndrome (CTS) diagnosed?

Carpal tunnel syndrome is a clinical diagnosis where a physician will listen to understand your symptoms and examine you in the clinic. A EMG is a test to measure the speed of the nerve and see where the entrapment might be. Other tests that that are helpful for evaluating CTS is ultrasound. Ultrasound is an excellent way to measure the swelling of the nerve to diagnose CTS without placing needles in the patient like an EMG.

What are treatment options for carpal tunnel syndrome (CTS)?

First line treatments include physical therapy and wearing braces at night. Physical therapy exercises might include nerve glide exercises to get the nerve to move more to give it more room. Next treatment options include steroid injections, or platelet rich plasma (PRP) to decrease inflammation around the nerve where the nerve is entrapped.

If nonsurgical treatments are not effective there are three surgical options for CTS. There is an open, endoscopic, and ultrasound guided approach. All three approaches are equally effective but there are some advantages of the ultrasound guided approach.

The ultrasound approach using Sonex allows Dr. Gruner to see the entire anatomy, while releasing the nerve, can be done in the office with local anesthesia, has a very small incision in the wrist compared to the hand, and can get back to activities within 5-7 days. Watch this video on the sonex procedure.

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Carpal Tunnel Syndrome Research

https://docs.google.com/document/d/e/2PACX-1vTYmf7ztgFy96BFprxYbWmZgcUMDReuVU6MDASyTjLkeidM7zBH_Y7ObURF3PKkY9aWlIjw99GvJukw/pub

https://pubmed.ncbi.nlm.nih.gov/32876476/
 

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