Carpal Tunnel

It’s easy to know why we might experience pain in our hands – because we’re always using them! They get very little rest and downtime. In addition to normal use, including grabbing, picking, throwing, etc., there are some people who use their hands on overload. Maybe by typing all day at a desk job, utilizing their hands for repetitive motions, or enjoying an active lifestyle that requires precise hand movements. While normal soreness is to be expected, there are times when light pain could be a red flag for something more problematic, which could be carpal tunnel syndrome. If you are concerned that your hand and wrist pain is getting worse, the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, and Chula Vista areas can help. 

What is Carpal Tunnel Syndrome?

Carpal tunnel is a health condition that causes pain, tingling, weakness and numbness in the hand and wrist. It is an extremely common condition that occurs in 3% to 6% of American adults, affecting a significantly larger amount of women than men. While carpal tunnel syndrome can occur at any age, it most often affects people between the ages of 40 and 60.

The carpal tunnel is a space in your wrist bones that is a passageway in the bones where tendons, ligaments and nerves pass through to innervate the hands. One of these nerves is the medial nerve, which helps a person to move their forearm, wrist, hand and fingers as well as provide sensation to the forearm and certain parts of the hand. Pressure on the median nerve causes carpal tunnel syndrome.

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome happens when something irritates or puts pressure on the median nerve. When this happens, the median nerve sends incorrect or additional feels to the hand and wrist. 

The most common causes that can cause compression on the median nerve include:

• Prolonged and repetitive flexion/extension of the wrist, usually from driving, typing and reading, or even from swinging a hammer or using a jackhammer for work
• Wrist fracture and subsequent inflammation
• Pregnancy that leads to swelling in the limbs
• Other medical conditions that have associated nerve dysfunction
• Strains
• Repetitive strain injuries

Additional causes that don’t have to do with repetitive or prolonged motion include rheumatoid arthritis, diabetes, obesity, gout and ganglion cysts. 

What Does Carpal Tunnel Syndrome Feel Like?

While some short-term discomfort is common after periods of hand and wrist overuse, pain that persists or provides tingling or numbing sensations could point to carpal tunnel syndrome. If you experience any or all of the below symptoms, it’s important to reach out to your pain management specialist who can properly diagnose and treat your specific condition. Symptoms include:

• Numbness, tingling or the feeling of “falling asleep” in the wrist, hands and fingers
• Sharp, burning, stabbing or constant ache that feels like it’s coming from inside the hand
• Inability to comfortably and securely grip
• The feeling that the hands and fingers can’t easily perform certain tasks, like buttoning a button
• Feelings of hand swelling
• Atrophy of hand muscles

How is Carpal Tunnel Syndrome Diagnosed?

A trained healthcare provider will diagnose carpal tunnel syndrome by performing a physical exam and taking diagnostic tests, including wrist X-rays, EMG and MRI. It’s important to tell your provider when you first felt the symptoms, what the symptoms feel like, and any specific movements or activities that make the symptoms worse. 

Diagnosing and treating carpal tunnel syndrome is important because, if untreated, the irritation in the wrist can cause permanent damage. The extra pressure can damage the medial nerve, which could make it very difficult or even impossible to feel, move or use your hand. 

What are the Best Treatments for Carpal Tunnel Syndrome?

The goal of carpal tunnel syndrome treatments is to reduce the frequency and intensity of symptoms, as well as prevent further damage. The good news is that most mild to moderate cases can be treated with conservative methods, and your healthcare provider will recommend the best options that work best for you and your lifestyle. Treatment options include: 

• At-home methods: minimize the overuse and repetitive methods, i.e. typing, as much as possible, or try changing your posture or work environment and using ergonomic office tools to allow for less strain on the wrist and hands themselves. A splint is also a great tool for keeping the wrist in a natural position, and stretching the wrist, arms and hands regularly is helpful for reducing irritation. 
• Physical therapy: a trained physical therapist can recommend an exercise regimen to help strengthen the wrist muscles and improve flexibility
• Over-the-counter medications: NSAIDs or Tylenol are helping for providing short-term pain relief, and a good tool to reduce pain and inflammation while taking advantage of physical therapy
• Corticosteroids: an injection of a steroid help to reduce inflammation and compression in the affected area of the carpal tunnel
• Surgery: if conservative methods have failed to provide relief in six months, surgical intervention is needed in most moderate to severe cases and is used to provide decompression of the median nerve. The surgery can be performed via open incision or endoscopically, with a goal to create more space inside the wrist. The provider will make a cut in the transverse carpal ligament, which is the ligament that connects the wrist to the palm, which reduces tension on the carpal tunnel and gives the tendons more space. Due to the fact that an incision is made, regardless of which surgical option, there is the opportunity for the development of scar tissue. This means that some patients still do not find pain relief, and other patients have a recurrence of symptoms months or years later. 

Even though there are several conservative methods that help to provide pain relief, the best way to avoid getting carpal tunnel syndrome is noticing any changes in the feeling of your wrist, hands and fingers, and addressing it immediately. This means making lifestyle changes and getting a professional diagnosis. It’s much easier to avoid getting the syndrome than ignoring the symptoms and signs and having to try to reduce pressure. 

If you are not sure if you have carpal tunnel syndrome or another issue in your wrist, please schedule an appointment with the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, and Chula Vista areas. Our team is expertly equipped to diagnose and treat all mild, moderate and severe cases of carpal tunnel syndrome, as well as offer conservative methods with a goal to reduce symptoms and progression.