Conditions & Treatments

Carpal Tunnel Syndrome

What is

Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers.

There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works, numbness, tingling, and pain may be felt in the hand and fingers.

What Causes

CTS?

Although there are several theories, what causes carpal tunnel syndrome is unclear. Pressure on the nerve can happen several ways:

  • Swelling of the lining of the flexor tendons, called tenosynovitis
  • Joint dislocations, fractures, and arthritis leading to narrowing of the tunnel
  • Keeping the wrist bent for long periods of time
  • Fluid retention during pregnancy that causes swelling in the tunnel and symptoms of carpal tunnel syndrome

Thyroid conditions, rheumatoid arthritis, and diabetes also can be associated with carpal tunnel syndrome. There may also be a combination of causes.

CTS Signs and

Symptoms

Carpal tunnel syndrome symptoms usually include pain, numbness, tingling, or a combination of the three. The numbness or tingling most often takes place in the thumb as well as the index, middle, and ring fingers. The symptoms usually are felt during the night but also may be noticed during daily activities such as driving or reading a newspaper.

Patients may sometimes notice a weaker grip, occasional clumsiness, and a tendency to drop things. In severe cases, sensation may be permanently lost and the muscles at the base of the thumb slowly shrink (thenar atrophy), causing difficulty with pinch.

Diagnosing

Carpal Tunnel Syndrome

A detailed history including medical conditions, how the hands have been used, and whether there were any prior injuries is important when diagnosing CTS. An X-ray may be taken to check for the other causes of the complaints such as arthritis or a fracture.

In some cases, laboratory tests may be done if there is a suspected medical condition that is associated with CTS. Electrodiagnostic studies (NCV–nerve conduction velocities and EMG–electromyogram) may be done to confirm the diagnosis of carpal tunnel syndrome as well as to check for other possible nerve problems.

Surgery &

Other Treatments

The symptoms of carpal tunnel syndrome may often be relieve without surgery. Our wrist doctor may recommend one or more of the following remedies:

  • Identifying and treating medical conditions that may be associated with a patient’s symptoms
  • Changing the patterns of hand use
  • Keeping the wrist splinted in a straight position to help reduce pressure on the nerve
  • Wearing wrist splints at night to relieve the symptoms that interfere with sleep
  • A steroid injection into the carpal tunnel to help relieve the symptoms by reducing swelling around the nerve

When symptoms are severe or do not improve, surgery may be needed to make more room for the nerve. Pressure on the nerve is decreased by cutting the ligament that forms the roof (top) of the tunnel on the palm side of the hand. Incisions for this surgery may vary, but the goal is the same: to enlarge the tunnel and decrease pressure on the nerve.

Following surgery, soreness around the incision may last for several weeks or months. The numbness and tingling may disappear quickly or slowly. It may take several months for strength in the hand and wrist to return to normal. Carpal tunnel syndrome symptoms may not completely go away after surgery, especially in severe cases.

If you are experiencing wrist pain, Dr. Arora can evaluate your condition for a thorough diagnosis. Braces for carpal tunnel syndrome treatment are also available right at each of the southeast Michigan offices, and they can be obtained via insurance or by cash pay.

Make an appointment to see him in Warren or Macomb Township in Macomb County, West Bloomfield in Oakland County, or Howell in Livingston County.

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.