Carpal tunnel syndrome, also known as median nerve compression, causes numbness, pain, and tingling in the affected hand. This is a result of pressure on the median nerve; the specific cause of the condition is unknown but it’s believed to be from both genetics and lifestyle.
The only permanent cure for carpal tunnel syndrome is surgery. However, there are several non-surgical treatments including exercise, corticosteroids, and splints that have been shown to help alleviate symptoms in mild cases of carpal tunnel syndrome.
Non surgical treatments
When diagnosed early enough, most patients can relieve carpal tunnel pain without surgery. Your doctor may recommend a variety of non-surgical options to help you alleviate symptoms. These are just a few exercises and options, but there are so many more to treat mild carpal tunnel pain. Your doctor may also recommend you see a professional physical therapist for more regimented exercises and treatment.
Providing your wrists a break from activities that exacerbate the condition only does so much. To find real relief, you should exercise and stretch the muscles.
Wrist flex and extend
-Hold your arm straight out in front of you with your palm facing down
-Let your hand fall to a 90-degree angle
-Use your other hand to gently pull your fingers towards the body and deepen the stretch
Switch after 30 seconds and repeat ten times
-It can be done throughout the day as needed
-Shake out your hands for 30 seconds to two minutes
Corticosteroids are a standard treatment to reduce swelling and inflammation. Oral corticosteroids are not an effective treatment, and your physician will most likely opt for injections. Studies have shown these injections are safe and provide immediate but short-term pain relief. A study done by Dr. Timothy Armstrong revealed 70% of patients found relief from injections.
These injections are not meant to be used too frequently as they could mask pain from nerve compression or permanent nerve damage. Too many injections could lead to irreversible nerve damage. The injections are also better suited to help diagnose carpal tunnel instead of a long-term treatment.
Wrist splints are only worn at night to relieve nighttime tingling and numbness. Keeping your wrist in a neutral position relieves the pressure on your median nerve. The splint can also help with daytime symptoms because you’re waking up with a less compressed nerve.
Dr. Brutus recommends wearing a splint at night only. After four to six weeks if symptoms have not improved or have worsened, you should consult your doctor about surgery. Wrist splinting is not a cure as with surgery but a study showed 54% of patients found symptom relief with splinting.
In addition to the above treatments, taking more breaks and using cold packs to reduce swelling are easy ways to ease symptoms. You should do your best to avoid overdoing activities that may worsen your symptoms.
However, once you begin to experience numbness, you should see a doctor as soon as possible. Numbness may be a sign of irreversible nerve damage or a character you require surgery.
If your pain has persisted or continued to worsen, your doctor may recommend you for carpal tunnel surgery. No one wants to undergo surgery, but it is a standard procedure performed on millions each year. Surgery will decompress the nerve and allow the fibers to reoxygenate properly.
There are two surgical methods for carpal tunnel syndrome, both of which have proven to be effective. The surgeries relieve pressure on the median nerve but cutting the ligament pressing on it. Be sure to discuss the techniques and risks with your surgeon before surgery. It will allow you to prepare for recovery as best you possibly can.
The open surgery method is what most hospitals will perform. The technique works by creating a two to three-inch incision on the hand. This procedure is more invasive because it requires the surgeon to cut through the skin, fatty tissue, and finally, the muscle to get to the transverse ligament. Once the surgeon reaches the ligament, it is divided to create an enlarged tunnel and alleviate pressure.
While this procedure is the most common, it has several disadvantages such as:
- -Loss of strength can last four to six months post-op
- -Hypersensitivity of the scar
- -Longer healing period
Endoscopic Release Surgery
Endoscopic release surgery is the most efficient way to treat carpal tunnel and is also the least invasive. This procedure can be performed in minutes under local anesthesia and does not require any stitches.
The surgeon starts by creating a 1cm incision on the wrist. The surgeon then inserts two miniaturized devices to divide the transverse carpal ligament as with the open surgery. The difference is that the rest of the muscle tissue and nerve fibers are not compromised.
Patients will have less down time, less pain and stiffness, and a smaller scar compared to the traditional open surgery method. Endoscopy also allows for both hands to be operated on at the same time unlike the traditional method. Endoscopic release surgery has a 98% to 99% success rate, especially if the surgery is performed early on.
Surgery may not be necessary in every patient if conservative treatments provide relief. However, if you are experiencing numbness, tingling, or conservative methods don’t provide relief you should consult your physician about surgery. Waiting too long to operate can lead to irreversible nerve damage and permanent loss of sensation.
Without surgery, nerves will be denied oxygen and eventually will die off which leads to numbness. When operated on early enough, the nerve fibers are allowed to re-oxygenate and heal themselves over time before it is too late.
Carpal tunnel syndrome is a common condition with plenty of treatment options. Consult with your physician on your options but keep in mind non-surgical treatments will only do so much. In the most severe cases or as time goes on, carpal tunnel surgery will be the only permanent solution.