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The carpal tunnel is a passageway through the wrist created by the small bones in your wrist known as carpals.
This passageway provides a route for the median nerve and the flexor tendons that bend your fingers and thumb to pass through. Nine flexor tendons pass through this opening.
Carpal tunnel syndrome occurs when the carpal tunnel narrows and places pressure on the median nerve. It can also happen when the synovium (the tissue surrounding the flexor tendons) swells and puts pressure on the median nerve restricting blood flow. This pressure causes the numbness and tingling of carpal tunnel syndrome.
If you suspect carpal tunnel syndrome is causing your discomfort, call Georgia Hand, Shoulder & Elbow to schedule an appointment at our Atlanta or Marietta, Georgia location.
Carpal tunnel syndrome symptoms can start small and progressively get worse. However, this is not the exact progression for every case.
The signs of carpal tunnel may include:
While every case is different, these symptoms are generally present when carpal tunnel is the issue. You might experience waking up feeling that your hand is asleep after a night’s rest. This occurs due to the prolonged compression of the median nerve as you sleep.
These are all symptoms of carpal tunnel syndrome.
Not seeking the proper treatment can lead to permanent nerve damage.
Carpal tunnel syndrome evaluations require a physical examination, in addition to the presence of the symptoms described above. Therefore, a carpal tunnel specialist is an excellent choice for providing a reliable evaluation.
Several factors can identify carpal tunnel, including:
When these symptoms are present, a doctor will perform a physical exam to determine if the problem is carpal tunnel and provide a correct diagnosis.
A physical examination of the hand happens in a doctor’s office. The doctor will perform several routine tests to determine if carpal tunnel is the true culprit. For example, the doctor may press on the median nerve and then test the fingertips for numbness, known as Tinel’s sign.
The doctor may also bend your wrist and evaluate what positions cause numbness. Or they may test the sensitivity of fingertips with your eyes closed. And they may check for atrophy of hand muscles or weakness in the muscles at the base of your thumb.
Your carpal tunnel doctor may also choose to conduct a test determining the speed at which the median nerve conveys information.
This is called a conduction test, which is frequently used to check for carpal tunnel. The median nerve will carry the information more slowly if carpal tunnel is the cause.
A doctor will also rule out other potential causes for numbness and tingling. For example, a pinched nerve in the neck will have many symptoms like carpal tunnel syndrome.
So this needs to be evaluated as well. X-rays, ultrasounds, and MRIs are also helpful in confirming a diagnosis.
The goal of treating carpal tunnel syndrome is to alleviate the pressure on the median nerve and resolve the symptoms. Mild symptoms can usually be treated by means of conservative treatment, including splinting or bracing.
Usually recommended for use at night, this will prevent unwanted bending or flexing of the wrist and help the carpal tunnel passageway remain open with less inflammation.
Treatment could include anti-inflammatory prescriptions to reduce the swelling applied to the median nerve. In addition, the corticosteroid injections applied directly to the inflamed synovium to reduce swelling can also be helpful.
However, these solutions are temporary as the reduction in swelling is not guaranteed to last permanently.
Once all other options have been exhausted, carpal tunnel surgery is next in line to provide relief and treatment. Carpal tunnel release surgery is a minimally invasive surgery.
Carpal tunnel release surgery uses an incision in the palm, allowing access to the carpal tunnel to manually increase the width and permanently relieve pressure on the median nerve.
Call Georgia Hand, Shoulder & Elbow to schedule a consultation at our Atlanta or Marietta location if you feel like you need a carpal tunnel specialist.
Randall Alexander, MD