Carpal Tunnel Syndrome / Numbness or Pain in the Hand

The carpal tunnel is an area in the wrist that is just like a tunnel/ canal through which structures of the hand pass from the forearm to the hand. It is made up of bones and ligaments. The structures passing through the tunnel are

• Median Nerve- this nerve is responsible for carrying the sensation of feeling from the hand and providing some strength to hand muscles. Pressure on this nerve causes numbness, pain, and weakness in the hand.
• Tendons of muscles that connect forearm muscles to the hand and help in the movement of fingers and hand.

Carpal tunnel syndrome/ numbness or pain in the hand occurs because of increased pressure on the Median Nerve. The function of Median Nerve includes:

• Sensory Supply to Hand. The Median Nerve carries the sensation of feeling or touch from the hand except for the pinky/ little finger. So, if the nerve doesn’t work, it will result in numbness, and the patient will not be able to feel the touch sensation.
• Motor Supply to Hand. Median Nerve also supplies some muscles of the hand, so the loss of power or weakness of the hand will be present.

Most cases of carpal tunnel cause is not known, but some risk factors are:

• Repetitive motion at wrist or fingers
• Playing sports like throwing, cycling, tennis
• Job involving vibration at the wrist at fingers
• Associated with other diseases
  a) Diabetes mellitus
  b) Thyroid diseases
  c) Pregnancy
  d) Rheumatoid arthritis or gout

The symptoms of Carpal Tunnel Syndrome include:

• Pain in hand, which increases at night
• Numbness, tingling, a feeling of pins and needles in fingers, crawling of insect in hands or loss of feeling of touch in hand
• Difficulty in performing daily activities like:
  a) Combing of hairs
  b) Holding of objects like phone or book
  c) Using a computer mouse and keyboard
  d) Writing
  e) Driving
  f) In severe cases, shrink of the base of the thumb in the hand

If not treated, Carpal tunnel syndrome results in permanent Median Nerve damage. This results in chronic pain and decreased movement and function of the hand.

Yes, it depends on the severity of Carpal tunnel syndrome. Home treatment is reserved for patients at the start of the disease process. If patients’ symptoms/ problems are not severe and it's the start of the disease, home treatment is the only thing the patient will need.

It depends on the severity of Carpal tunnel syndrome, the associated condition with Carpal tunnel syndrome, when the treatment has started, and how the patient has responded to treatment. Usually, it takes from a few months to a year.

Mainly clinically, your surgeon will examine you; x-rays, MRI, EMG, and NCV tests are done.

Most cases of Carpal tunnel syndrome are treated with non-surgical methods. Surgery is done in only some cases where proper indications are present.

• Rest- don’t overuse and try to decrease activities that cause an increase in problems/ symptoms
• Ice packing
• Use of splints
• Pain killers
• Physiotherapy
• Correcting or avoiding some activities which increase symptoms/ problems
• While using the keyboard, keep your hand, wrist, and forearm in a straight line
• Support wrist with mouse pad

Surgery is recommended for the following:

• Cases which have taken treatment for long and problems are still present
• Chances of damage to Median Nerve is present/ has occurred
• After taking treatment for a long time, some of the problems are still present and not improving

A final decision has to be taken in consultation with the surgeon

Surgical treatment of Carpal Tunnel syndrome involves”

• Carpal Tunnel Release- this involves cutting of TRANSVERSE CARPAL LIGAMENT

It can be done

a) Mini open- use of minimal cut to open and cut the ligament
b) Endoscopically- use of camera and other instruments are inserted with the small cuts and used to cut ligament

Many patients ask about the difference between both surgeries. Many studies have said that results and safety are comparable without any difference between both. In the world, a maximum number of surgeries are done through the mini-open technique, and few surgeons use the endoscopic technique.

The patient will feel the difference within a few days of surgery. But the ultimate result depends on; how long the disease is present, how much nerve is damaged, and the associated illness with carpal tunnel syndrome.

Usually, for one day after carpal tunnel release, the patient can even go home the same day.

The complications or Carpal Tunnel involve:

• Infection
• Damage to nerves
• Damage to blood vessels

Usually, a patient will be able to perform routine activities in 6-8 weeks. But in severe cases with nerve injury, full recovery can take up to 6 months to a year.

Try the following tips:

• Don’t hold things too tightly. Make a habit of holding them softly
• Stretch before and after a workout or working for a long time. Show a high five with a gap in your fingers and make a fist. Repeat this 15-20 times.
• Rest-take frequent breaks if your jobs involve the use of similar movements for a long time
• Use of both hands. Don’t do everything with one hand only
• In cases of pain and numbness, wear the splint
• While using the keyboard, keep your hand, wrist, and forearm in a straight line
• Support wrist with mouse pad
• Please also treat associated conditions

Carpal tunnel release is a successful surgery, with most patients happy. In a few cases where nerve damage was present before surgery, recovery will not be complete. Always make decisions in consultation with the surgeon about treatment.

It depends on the hospital category chosen by the patients. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and included complete after-surgery services, which patients require after surgery because we know treatment doesn’t end at the patient's discharge. To ensure the quick recovery of patients in simpainortho.com, we believe that a patient requires expert care within the most comfortable surroundings until he/she can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most insurances have included carpal tunnel release surgery.