Carpal tunnel syndrome is a common disorder of the wrist that frequently brings patients to Long Island Spine Rehabilitation Medicine. Though not a terribly serious condition, it can make life much more difficult for those who suffer with it, especially if their occupations worsen its symptoms.
Named for the “tunnel” that protects the tendons and median nerve that pass from the forearm through the wrist to the hand, carpal tunnel syndrome is characterized by pain, tingling and numbness. These symptoms result from pressure on the median nerve that in turn causes thickening and swelling of the adjacent tissues.
Such chronic compression of a nerve is called “entrapment neuropathy,” and carpal tunnel is the most common manifestation of this disorder, responsible for 90 percent of all cases. Because the carpal tunnel is a narrow passage to begin with, surrounded by bones and ligaments on the palm side of the hand, it doesn’t take much to compress the enclosed nerve and adversely affect the hand and fingers. Because the median nerve provides sensation to the palm side of the thumb and fingers (except the little finger), and motor ability to the base of the thumb, it is no surprise that these are the parts most affected by its compression.
To understand the causes of carpal tunnel, we have to return to the idea that its symptoms result from compression of the median nerve. Anything that causes such pressure can result in the pain associated with the disorder. In many cases, there is not a single cause, but rather a combination of factors that may include:
- Congenital anomalies or deformities of the wrist (e.g. exceptionally small wrist bones)
- Wrist fractures or other injuries
- Rheumatoid arthritis or other inflammatory conditions
- Overuse of a computer keyboard and mouse (not a proven cause)
- Occupations that requires frequent, repetitive flexing of the wrist (like assembly line work) or vibrating motions (like certain kinds of construction)
- Degenerative osteoarthritis
- Chronic illnesses, like diabetes, congestive heart failure, and lymphedema that may increase risk of nerve damage due to fluid retention
- Being female — carpal tunnel is more common in women, believed to be a result of their typically smaller wrists, and hormone irregularities that result in fluid retention
- Certain medications, such as Arimidex, a drug used for treating breast cancer
Obesity and smoking, contributing factors in so many health problems, are also considered risk factors for carpal tunnel.
Diagnosis of Carpal Tunnel
At Long Island Spine, one of the disciplines our doctors specialize in is diagnosis of musculoskeletal conditions, including carpal tunnel syndrome. This condition, like so many others, heals best when it is treated early on, before permanent damage has occurred. Therefore, it is a good idea to make an appointment with one of our conveniently located offices throughout Nassau, Suffolk, and Queens Counties as quickly as possible.
Our professional staff has the in-depth knowledge and hands-on training that ensure confidence. We are well-prepared to diagnose you by:
- Taking a comprehensive medical history
- Performing a thorough physical exam
- Administering an EMG (electromyography) and NCS (nerve conduction study) test
The EMG NCS test will not only determine whether you have carpal tunnel, but its severity in your particular case.
Symptoms of Carpal Tunnel
The symptoms of carpal tunnel generally come on gradually. Patients begin to notice that they are experiencing some pain, numbness, and a pins and needles sensation in their thumb, index finger, middle finger and the radial half of their ring finger (the thumb side) — not the little finger. On occasion, the pain or sensations may feel like electric shocks, radiate up the affected arm, or be associated with weakness in the affected hand.
Patients sometimes experience a worsening of symptoms at night or when they engage in activities that require tight gripping, such as holding the steering wheel of a car, opening a jar, pushing a baby carriage, moving a computer mouse for an extended period, or playing video games. Patients are often troubled by numbness in the hand when they wake up in the morning. Typically, if left untreated, symptoms become more prevalent until they are more or less constant.
Treatments for Carpal Tunnel Syndrome
At Long Island Spine, there are several ways we can help you recover from carpal tunnel problems, including:
- Physical and occupational therapy targeting the hand and wrist
- Wrist bracing for support to relieve pressure
- Activity modifications — e.g. allowing for rest periods; performing activities in ways that don’t stress the wrist
- Administration of prescribed and/or over-the-counter anti-inflammatory medications
- Corticosteroid injections to the wrist guided by ultrasound
- Platelet rich plasma (PRP) injections to accelerate healing
Although carpal tunnel can most often be treated nonsurgically, particularly if addressed early on, there are situations in which the condition calls for an operation. In such cases, Long Island Spine will refer you to a fine surgeon who specializes in hand surgery/neurology.
Don’t Let Your Carpal Tunnel Get Out of Hand — Contact Long Island Spine Today
As with so many musculoskeletal conditions, the earlier you seek professional help for carpal tunnel, the sooner you are likely to see improvement. Let our skilled, compassionate physiatrists diagnose and treat you before your carpal tunnel worsens. Acting promptly can keep the condition from interfering with your daily activities, preventing you from working, or even deteriorating to the point that surgery may be required. Please contact our office today to set up a consultation.