Carpal tunnel syndrome

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Surface anatomy - normal wrist

Compression of the median nerve

Carpal tunnel surgical procedure

Overview

Symptoms

Treatment

Prevention

Carpal tunnel syndrome

Alternative Names:

Median nerve dysfunction

Treatment:

The first line of treatment may be wearing night splints for the wrist for several weeks. If unsuccessful, the splints are worn during the day and heat or cold compresses may be added.

Modifications in the work area (particularly ensuring that the keyboard is low enough so that the wrists aren't bent upward during typing), work duties, or recreational activities may be necessary. Some of the jobs associated with carpal tunnel syndrome include those that involve typing or use of vibrating tools; mining; and professional musicians.

There are many specialized devices designed to be used in the workplace to reduce the stress placed on the wrist and improve carpal tunnel syndrome and these should be used when possible.

MEDICATIONS:

Medications used in the treatment of carpal tunnel syndrome include anti-inflammatory analgesics (NSAIDs such as ibuprofen or naproxen). The carpal tunnel may also be injected with corticosteroids. This may provide dramatic relief of symptoms. (Note: It is the carpal tunnel space that is injected, not the nerve.)

SURGERY:

Carpal tunnel release is a surgical procedure that cuts into the ligament to relieve pressure on the median nerve. Surgery is successful about 85% of the time, depending on the severity of the problem. Surgery reduces the pressure on the nerve, but the damaged nerve must heal for the symptoms to improve. This can take months and in severe cases the nerve may be incapable of fully healing.

In severe cases, electromyography or nerve conduction studies may be used to follow the recovery of the nerve.

Expectations (prognosis):

Symptoms often improve with treatment but more than 50% of cases eventually require surgery. Surgery is often successful but full healing can take months.

Complications:

If the condition is treated properly, there are usually no complications. If untreated, the nerve can be damaged, causing permanent weakness, numbness and tingling.

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of carpal tunnel syndrome.

Call your health care provider if symptoms of carpal tunnel syndrome do not respond to treatment, or if there seems to be a loss of muscle mass in the fingers.

Review Date: 8/3/2004
Reviewed By: Kevin B. Freedman, M.D., Section of Sports Medicine, Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.

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