Carpal tunnel syndrome (CTS) is a condition caused by increased pressure on the median nerve at the wrist. There is a space in the wrist called the carpal tunnel, where the median nerve and multiple tendons pass from the forearm into the hand. Carpal tunnel syndrome happens when swelling in this tunnel pinches, or compresses, the nerve.
The Comprehensive Hand Center team specializes in the treatment of carpal tunnel syndrome, from mild to severe. Our goal is to restore comfort and function as soon as possible with minimal impact on the patient’s quality of life.
Risk Factors for Carpal Tunnel Syndrome
There are several factors that can contribute to the swelling of the carpal tunnel and the compression of the median nerve that can lead to carpal tunnel syndrome:
- Chronic illnesses such as hypothyroidism, rheumatoid arthritis and diabetes
- Repetitive hand and/or wrist movements, especially if the wrist is bent so that the hands are lower than the wrists
Symptoms of Carpal Tunnel Syndrome
Common signs and symptoms of carpal tunnel syndrome include:
- Weakness with grip
- Tendency to drop things
- Poor sleep due waking up at night due to pain and tingling in the hand
- In severe cases, thinning of the muscles in the palm
The numbness and tingling often happens in the thumb, index, middle, and ring fingers. This may vary between individual patients.
Diagnosis of Carpal Tunnel Syndrome
A thorough physical examination and discussion of the patient’s medical history, including current and past conditions, prior injuries and symptoms, will help diagnose carpal tunnel syndrome.
Depending on the examination of the patient’s hands, additional diagnostic tests may be needed to confirm the presence and extent of carpal tunnel syndrome. These include:
- Electrodiagnostic nerve studies (EMG)
- Laboratory tests
Treatment of Carpal Tunnel Syndrome
Treatment will depend on the severity of symptoms, which may be relieved without surgery.
There are several non-surgical treatment options that may help relieve symptoms and reduce the chance of causing long-term damage to the nerve. These include:
- Avoiding activities that cause numbness and pain
- Rest for longer periods of time between activities that cause numbness and pain
- Ice wrist area
- Anti-inflammatory medications such as ibuprofen
- Wearing a wrist splint
- Corticosteroid injections into the carpal tunnel
When symptoms are severe or do not improve, surgery may be the next step. Pressure on the median nerve is decreased with surgical release of the ligament over the carpal tunnel.
Hand Therapy and Rehabilitation for Carpal Tunnel Syndrome
Therapy for carpal tunnel syndrome is recommended in some cases. It is provided on site at the University of Michigan’s Hand Program by our team of occupational and physical therapists under the direction of a trained hand therapist. Referrals to local providers can be arranged closer to home as a more convenient option for patients.
The ultimate goal of therapy and rehabilitation is the restoration and optimization of hand function, renewed independence and improved overall quality of life. We offer treatment plans that are tailored to fit each patient’s condition, living and work requirements:
- Non-surgical option: For patients who do not require surgery but would benefit from therapy.
- Post-operative rehabilitation: To help patients as they recover from surgical procedures.
If you are considering treatment for carpal tunnel syndrome, the University of Michigan hand surgeons will guide you, from consultation to recovery, to the best treatment options for your individual needs. Our hand surgeons have dual appointments in Orthopaedic and Plastic Surgery with a specialization in Hand. Patients may be seen in the Orthopaedic Clinic or the Plastic Surgery Clinic for treatment of hand conditions, or referred to Physical Medicine and Rehabilitation for non-surgical treatment.
Visit the Make an Appointment at the Comprehensive Hand Center page for contact information for both surgical and non-surgical treatment teams.