Carpal Tunnel Syndrome, Part 1

Post provided by Robert Foster, MD.

In 2009 over one million people sought medical treatment for carpal tunnel syndrome (CTS). It is estimated that carpal tunnel syndrome affects nearly three percent of the population, or over 8 million people in the United States alone. Despite simple and effective treatments, many people continue to needlessly suffer with symptoms of CTS.

Carpal tunnel syndrome is caused from compression of the median nerve as it passes through the carpal tunnel at the wrist. The median nerve is responsible for supplying sensation to the thumb, index finger, middle finger, and part of the ring finger. Compression of the nerve causes slowing of the electrical signal that can result in a multitude of symptoms, such as numbness, tingling, burning, aching, weakness, and radiating discomfort up the arm.

Carpal tunnel syndrome is not caused from working on the computer or repetitive key stroking. In fact, most cases of CTS do not have an exact identifiable cause. However, repetitive motion activities, such as typing on a keyboard, can aggravate carpal tunnel symptoms in those who have it. Conditions frequently associated with or cause an increase risk of carpal tunnel syndrome include pregnancy, obesity, trauma, smoking, diabetes, hypothyroidism, rheumatoid arthritis, and kidney disease.

Treatment of carpal tunnel syndrome can be conservative or surgical. Conservative treatments include splinting, therapy, oral medications, and steroid injections. Splinting and steroid injections are the most common and effective conservative measures. Splinting is effective because it prevents excessive flexion of the wrist, which can increase pressure on the median nerve within the carpal tunnel space. Steriod injections into the carpal tunnel space decrease inflammation and swelling, which relieves pressure on the median nerve and improves blood flow to the nerve tissue. While usually not a permanent cure, steriod injections frequently can improve symptoms for a prolonged period of time and are often used in conjunction with wrist splints. Physical therapy and oral medications are less effective for the long term treatment of carpal tunnel syndrome. Other therapy modalities such as laser therapy, heat therapy, and chiropractic care seem to have less or even no effect.