Carpal tunnel syndrome

Carpal tunnel syndrome is basically a pinched nerve (the median nerve) at the wrist, in a fixed-volume structure called the carpal tunnel. Pressure can increase in the tunnel for various reasons, resulting in the nerve becoming entrapped and damaged.

What causes carpal tunnel syndrome?

Most cases are related to swelling around the flexor tendons in the wrist. This can be secondary to inflammation, diabetes, thyroid disease, arthritis, pregnancy or overuse of the wrist with repetitive wrist movements or gripping.

What are the symptoms?

Patients complain of pain and burning sensation in the hand and fingers, at night or in the early morning. As the condition progresses, patients experience these symptoms with benign activities, like driving, or reading the paper. Over time, they start loosing sensation in the thumb, index and middle fingers. Loss of muscle tone and power in the thumb can follow.

How to diagnose it?

Clinical examination is performed by your hand surgeon and shows positive:

  • Tinel’s test: Tapping the skin over the nerve at the wrist reproduces the symptoms.
  • Phalen’s test: When the patient keeps the wrist flexed for a little while, symptoms are reproduced.
  • Sensation or feeling disturbance in fingers.
  • Muscle weakness in the thumb

Additional tests

  • Electrodiagnostic tests (EMG) are used to assess the severity of the condition and rule out another cause for the symptoms.
  • Cortisone injection can be helpful to diagnose when the EMG is negative in spite of a high clinical suspicion.

Answer all the questions and you will receive our free guide, Self Help book for Carpal Tunnel syndrome: the essential guide to a quick recovery.

1. Does your work or personal occupation cause you to perform repetitive manual actions? ( Question 1 / 15 )

2. Do you suffer from numbness or frequent tingling sensations in the palm of your hand or in your fingers (especially thumb, forefinger and middle finger)? ( Question 2 / 15 )
3. Do you feel tingling and numbness especially in your thumb, forefinger, middle finger and fourth finger rather than your little finger? ( Question 3 / 15 )
4. Do you feel numbness or tingling in your fingers when you read a newspaper, drive a car or talk on the phone? ( Question 4 / 15
5. Do you feel numbness in your hand or hands when you raise them above your head? ( Question 5 / 15 )
6. Do you often feel a burning sensation in the palm of your hand or at your fingers? ( Question 6 / 15 )
7. Do you need to shake your hand or hands to try to relieve numbness? ( Question 7 / 15 )
8. Do your fingers seem swollen or clumsy, even if the swelling is not obvious? ( Question 8 / 15 )
9. Do the symptoms seem greater at night or on waking? ( Question 9 / 15 )
10. Have you ever awakened at night feeling the need to shake your hand to alleviate the symptoms? ( Question 10 / 15 )
11. Does splinting at night alleviate symptoms? ( Question 11 / 15 )
12. Do you feel weakness in your hand or wrist? ( Question 12 / 15 )
13. Have you noticed any discomfort or awkwardness when holding objects in your hand or trying to perform certain motions? ( Question 13 / 15 )
14. Do you have difficulty buttoning your clothes or handling small objects? ( Question 14 / 15 )
15. Do you have symptoms in both hands? ( Question 15 / 15 )

Functional treatment

Night splinting of the wrist and rest can alleviate the symptoms early. A cortisone injection can be a temporary measure for patients who cannot have carpal tunnel surgery.

Surgery

There are two acceptable procedures:

  • Open procedure: The open procedure involves an approximately 3 to 4 centimeter incision in the palm. The skin, subcutaneous tissue palmar muscle, and finally the transverse carpal ligament are divided to relieve pressure on the median nerve.
  • Endoscopic procedure: a very small incision at the wrist or forearm allows to inspect the inside of the carpal tunnel with a mini camera and to divide the transverse carpal ligament only, leaving the skin, subcutaneous tissue and muscle intact. This is the least invasive surgical method and allows a much quicker recovery than the open procedure.

*Results may vary

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Relieve your pain quickly

Relieve your pain quickly

Download our free guide on the carpal tunnel syndrome

Self help book for carpal tunnel syndrome: The essential guide to a quick recovery

Dr. Jean-Paul Brutus and Nathalie Brisebois (Occupational Therapist) answer the most frequently asked questions about carpal tunnel syndrome and offer advice to treat the disease without surgery.

Self help book for carpal tunnel syndrome:The essential guide to a quick recovery

Dr. Jean-Paul Brutus and Nathalie Brisebois (Occupational Therapist) answer the most frequently asked questions about carpal tunnel syndrome and offer advice to treat the disease without surgery.

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