What is Carpal Tunnel Syndrome?

The Carpal Tunnel is an anatomic structure in the wrist formed by the small carpal bones posteriorly and the carpal ligament anteriorly.  Tendons, the connective tissue between the muscles and the bones they move, along with the median nerve that carries signals between the spinal cord and the hand, pass through this structure.

If the tendons become swollen, as may happen from overuse, the swelling may compress the adjacent median nerve producing the pain, numbness, and tingling of Carpal Tunnel Syndrome.

How is Carpal Tunnel Syndrome Diagnosed?

A clinical diagnosis of Carpal Tunnel syndrome is made when symptoms of the condition such as pain in the hand and forearm, numbness and tingling in the fingers, and often worsening of the symptoms at night, are present.  Confirmation of the diagnosis and an assessment of the severity of the nerve impingement is obtained by nerve conduction and EMG testing.

How is Carpal Tunnel Syndrome Treated? 

Treatment of Carpal Tunnel Syndrome should begin as early as possible.  Medications useful in helping relieve the symptoms of Carpal Tunnel Syndrome include anti-inflammatories (NSAIDs), various analgesics, corticosteroids such as prednisone (taken orally) or injectible steroids administered directly into the carpal tunnel, and on occasion diuretics to reduce fluid and swelling.

Physical therapy has an important role in the treatment of Carpal Tunnel Syndrome and uses stretching and strengthening exercises to help alleviate the symptoms, and is best obtained with a certified hand therapist.  

Alternative therapies such as chiropractic and acupuncture may benefit some patients but their effectiveness remains unproven.  Yoga may in particular be of benefit to some patients however.

Carpal tunnel release sugery is commonly performed for more severe or refractory cases of Carpal Tunnel Syndrome.  Surgery may be performed as an open release or may be performed endoscopically, and in either case can be performed under local anesthesia and does not require an overnight hospital stay.  Recurrence of Carpal Tunnel Syndrome after surgery is rare and the majority of patients recover completely.