Carpal Tunnel Syndrome
Carpal tunnel syndrome is a compression of the median nerve as it travels through the carpal tunnel in the wrist. The carpal tunnel is a tight, confined space where tendons and nerves pass through at the wrist. Patients with carpal tunnel syndrome experience numbness and tingling in their thumb, index and middle finger. The symptoms are particularly noticeable at night, with the patient often waking up and having to "shake out" their hand in order to get comfortable. Carpal tunnel syndrome is generally a result of repetitive motions of the hand, like typing at a computer.
The diagnosis of carpal tunnel syndrome is largely based on the patient's history. In addition to patient history, an EMG study can be done to confirm the diagnosis. An EMG is an electrodiagnostic study that examines how well the nerves are conducting electrical signals. The initial treatment of carpal tunnel syndrome is rest and immobilization with a wrist splint. The splints are particularly helpful in reducing nighttime symptoms. If the splint does not relieve the numbness and tingling associated with carpal tunnel syndrome, surgical treatment may be necessary. Surgical treatment involves releasing the tunnel that is compressing the median nerve. The surgery may be performed with an endoscope or with an open incision. Physical therapy is generally not needed after surgical treatment. Patients may return to work as soon as they are comfortable, typically 1-2 weeks, depending upon their job.