Many people who experience hand pain and numbness come into the office concerned that they may have carpal tunnel syndrome (CTS). While hand pain is certainly one symptom of the notorious CTS, it is important to note that all hand pain is not necessarily carpal tunnel syndrome. Classic symptoms of CTS include numbness, tingling and a burning type of pain extending into the fingers supplied by the median nerve. Affected fingers commonly involve the thumb; index, middle and half of the ring finger. If numbness and a burning sensation are not present in these digits, it is unlikely that CTS is present. Albeit, there are numerous conditions that bring about pain in the hand; each is important to properly diagnose and treat.
Carpal tunnel syndrome occurs when the large nerve called the median nerve is compressed as it passes through a narrow tunnel in the wrist. The carpal bones in the wrist form an arch. Stretched tightly over the top of the arch is tough ligament that forms a rigid roof to this arched bone structure. The median nerve, along with nine tendons, passes through this opening. As you perform the daily tasks that bend your wrist such as driving a car, holding a phone or sitting at a workstation or computer, there is a risk of irritating the median nerve. The bend in the wrist causes increased pressure on the nerve, which decreases the blood flow to the nerve. This limited blood supply results in the nerve sending out warning signals like tingling, pain and numbness to the brain to alert the body to a potential problem.
Typically, people first notice the characteristic symptoms of CTS at night. When we sleep, we naturally curl up and it is common to unconsciously bend our wrists. This curled wrist position often irritates the nerve causing numbness and pain which wakes us up and we change positions. The first line of treatment is to use a wrist splint to be worn only at night to keep the wrists straight this will keep pressure off the nerve and let it recover and rest like other parts of the body. Of course, if CTS is in the more advanced stages, a splint may not relieve the pain. Advanced CTS is characterized by a constant numbness and often weakness no matter what you do.
Certain risk factors increase the likelihood of CTS including age, obesity, female gender, diabetes, hypothyroidism, and pregnancy to name a few. Trauma, such a wrist fracture, may also cause CTS. There are numerous associated causes of carpal tunnel syndrome and a number of conditions that can mimic these symptoms. For proper diagnosis and treatment, schedule an appointment with a surgeon who is experienced in hand surgeon and who is specially trained to properly identify and treat wrist and/or hand conditions. As with most conditions, early diagnosis and intervention is important for avoiding permanent nerve and muscle damage.
Our philosophy at the Idaho Hand Institute is to begin treatment with the least risky and most proven interventions. We look to treatments that have the highest success rates. Most of the time, patients are able to get relief from symptoms by altering activities, using prescribed medications, splinting and therapy. However, if conservative techniques are not successful in relieving a patient's problem, surgery may be required. An experienced hand surgeon can discuss the best options with you. To best serve our patients, we see patients daily in Pocatello, at the Lakeview Medical Clinic in Soda Springs every other Friday and in the Blackfoot Medical Clinic every other Wednesday. For more information or to schedule an appointment in Pocatello, Soda Springs or Blackfoot please contact us at the Idaho Hand Institute, 208-235-4263.