Advanced Bone & Joint

Carpal Tunnel Syndrome: Insights From Hand Specialists on Diagnosis and Treatment

Carpal tunnel syndrome (CTS) is a repetitive motion injury that affects the motion and strength of the hand and wrist. If you are experiencing reduced grip, along with numbness, tingling, and pain in the thumb, index finger, middle finger, and the top half of the ring finger, you may have CTS.

A hand specialist can diagnose and treat this common musculoskeletal condition.

Symptoms of Carpal Tunnel Syndrome

Carpal tunnel syndrome symptoms develop when too much pressure and tension is placed on the median nerve and its associated blood vessels. This pressure comes from repetitive motions, such as keyboarding and hammering. This pressure can narrow the bony tunnel that runs through the wrist, causing:

  • Reduced grip strength, particularly in the thumb and index finger
  • Numbness
  • Tingling
  • Pain that can radiate up the wrist into the forearm, upper arm, and shoulder (when severe)

Symptoms are often worse at night when the wrist flexes, or goes limp, as a person sleeps.

Causes of Carpal Tunnel Syndrome

Women ages 30 to 60 are most prone to this common orthopedic condition, but people of all ages and walks of life can develop it, particularly if they have thyroid disease or diabetes. Individuals with rheumatoid arthritis and previous wrist fractures and dislocations can have varying degrees of CTS, too.

Predisposing factors include heredity, pregnancy, premenstrual syndrome, and menopause.

Diagnosis and Treatment of Carpal Tunnel Syndrome

When you see a hand specialist regarding your symptoms, they will review your medical history and perform some tests to confirm or rule out carpal tunnel syndrome. These assessments may include:

  • X-rays
  • Nerve conduction studies (NCS) to measure the speed and strength of nerve impulses moving from the hand up the arm
  • Electromyography to detect the strength of electrical impulses in muscles in the wrist and arm
  • Phalen’s test, in which the patient flexes and extends the wrist to evoke the symptoms of CTS
  • Tinel’s sign, which is produced when the doctor taps the median nerve in the wrist, producing numbness and tingling in the patient’s hand

As the doctor considers the findings from these assessments, they will determine a treatment plan to control symptoms and keep CTS from worsening. Elements of care plans can include:

  • NSAIDS, such as over the counter ibuprofen, to control inflammation and pain
  • Night time splinting to keep the wrist straight during sleep
  • Use of splints or Ace bandages when typing or doing other repetitive motions
  • Cortisone injections to relieve pain and swelling
  • Surgery

Surgery is a last resort for CTS. However, if the hand specialist recommends it, this outpatient surgery typically is done with small instruments and a lighted endoscope. A small notch is cut into the transverse carpal ligament, which is on top of the carpal tunnel in the wrist.

This notch immediately relieves pressure, and as the patient recovers over the subsequent days, symptoms of CTS resolve quickly. Follow-up physical therapy helps patients regain flexibility, dexterity, and strength in the hand and fingers.

Insights From Your Hand Doctor in Wentzville, MO

At Advanced Bone & Joint, our orthopedic specialists help people regain function lost to inflammatory and repetitive motion injuries, such as carpal tunnel syndrome, tendonitis, bursitis, plantar fasciitis, and more. Our in-house hand expert is Dr. Colleen Glisson. She practices out of our St. Peters and O’Fallon, MO, offices.

Call today to arrange a consultation about your CTS symptoms: (636) 229-4222, or request your appointment by filling in our convenient appointment request form.