What Is Carpal Tunnel Syndrome (CTS)?

When you hear the words ​“carpal tun­nel syn­drome,” your mind might imme­di­ate­ly jump to wrist pain.

Carpal tun­nel syn­drome, or CTS, caus­es more than pain. It also caus­es numb­ness, weak­ness, and that ​“pins and nee­dles” feel­ing. It’s extreme­ly com­mon – in fact, it’s one of the most com­mon hand conditions.

New to CTS? Here are answers to com­mon ques­tions about the condition.

What Exact­ly Is Carpal Tun­nel Syndrome?

The carpal tun­nel is a nar­row pas­sage­way in your wrist on the palm side of your hand. It’s made of ten­dons, lig­a­ments, and bones.

One of the main things that pass­es through the carpal tun­nel is the medi­an nerve. This is a nerve that helps you move your fore­arm, wrist, hand, thumb, and three mid­dle fin­gers. It also sends sen­sa­tions (like touch, tem­per­a­ture, and pain) from your hand and low­er arm to your brain.

CTS is when there is too much pres­sure on the medi­an nerve, which hap­pens when the nerve gets irri­tat­ed, com­pressed, or squeezed as it pass­es through the tunnel.

If you think you have carpal tun­nel syn­drome, call to sched­ule an appoint­ment with a South Bend Clin­ic ortho­pe­dic spe­cial­ist. For qual­i­fy­ing patients, Dr. Akre can per­form a carpal tun­nel release right in the office using local anes­the­sia at either the South Bend or Granger loca­tion. No hos­pi­tal vis­it required, and you can dri­ve your­self home the same day.

What Does CTS Feel Like?

Symp­toms of CTS usu­al­ly begin grad­u­al­ly, rather than after an injury. They may come and go in the ear­ly stages, but they tend to hap­pen more fre­quent­ly and for longer peri­ods of time as CTS gets worse.

The tell­tale signs of CTS are tin­gling, numb­ness, and pain in the wrist, hand, or fin­gers (espe­cial­ly at your fin­ger­tips). This can feel like an elec­tric shock in your fin­gers and can wake you up in the mid­dle of the night. Some­times, the sen­sa­tion trav­els up to your arm.

One of the oth­er main symp­toms of CTS is weak­ness and clum­si­ness in your hand. It might make it dif­fi­cult to do fine move­ments (like but­ton­ing a shirt or writ­ing) or cause you to con­stant­ly drop things.

Read on Duly Health and Care: Is Clum­si­ness a Sign of a Health Problem?

What Caus­es CTS?

Any­thing that puts extra pres­sure on your medi­an nerve can cause CTS. The pres­sure often hap­pens when one part of your wrist is dam­aged or swollen and it push­es on the tis­sue and medi­an nerve around it.

For exam­ple, if you break your wrist, the carpal tun­nel can become nar­row­er. The medi­an nerve has less space to pass through, so it can have more pres­sure put on it and become irritated.

There can be mul­ti­ple fac­tors caus­ing CTS. In oth­ers, it’s not clear what caused CTS to devel­op. Either way, it’s not always easy to pin­point a sin­gle cause of CTS.

What Makes Some­one More at Risk for CTS?

Sev­er­al risk fac­tors are linked with CTS, even if they don’t direct­ly cause it. Risk fac­tors include:

• A nat­u­ral­ly small carpal tun­nel (which tends to run in families)
• Con­di­tions that can cause medi­an nerve dam­age, like diabetes
• Inflam­ma­to­ry con­di­tions, like rheuma­toid arthri­tis and gout, that cause swelling and put pres­sure on the medi­an nerve
• Con­stant­ly doing repet­i­tive motions with your hands or wrists, like swing­ing a hammer
• Repeat­ed­ly using vibrat­ing machin­ery or tools
• Preg­nan­cy
• Obe­si­ty
• Trau­ma to the wrist
• Old­er age
• Being assigned female at birth

Can Fre­quent Typ­ing Cause CTS?

It’s pos­si­ble for heavy com­put­er usage and typ­ing to increase your risk for CTS, but it’s nev­er been proven to be a direct cause. That said, it’s impor­tant to pay atten­tion to your com­put­er use habits. Using an incor­rect­ly-posi­tioned key­board or mouse can cause oth­er types of wrist pain.

When typ­ing, make sure to:

• Arrange your key­board and mouse for your body size and height to avoid over­work­ing your wrists. 
• Keep your wrists and fore­arms neu­tral or almost straight to reduce strain on the wrists.
• Take breaks to move and stretch.
• Try to switch between sit­ting and stand­ing as you work, since this strength­ens ten­dons and loosens joints.

Read on Duly Health and Care: Upgrad­ing your Work-From-Home Space

Will I Need Surgery for CTS?

There are many ways to treat CTS, and the most com­mon ones are non­sur­gi­cal. Exam­ples include:

• Wear­ing a splint (usu­al­ly while you sleep). The splint holds your wrist in place in a neu­tral posi­tion, keep­ing pres­sure off the medi­an nerve.
• Doing cer­tain exer­cis­es that strength­en and stretch your wrist and increase flex­i­bil­i­ty. You may ben­e­fit from doing exer­cis­es with a phys­i­cal or occu­pa­tion­al therapist. 
• Mak­ing adjust­ments to your pos­ture or work envi­ron­ment. You may need to tweak how you stand, sit, or posi­tion your keyboard.
• Get­ting cor­ti­cos­teroid injec­tions. These are pre­scrip­tion anti-inflam­ma­to­ry med­ica­tions that decrease pres­sure on the medi­an nerve and relieve pain.

For short-term pain relief, your provider may rec­om­mend over-the-counter med­ica­tions, like aceta­minophen (Tylenol®) or ibupro­fen (e.g., Advil®, Motrin®). How­ev­er, you shouldn’t take these med­ica­tions more than 10 days in a row with­out talk­ing to your provider.

What Hap­pens If I Need Carpal Tun­nel Surgery?

If CTS symp­toms are severe or aren’t get­ting bet­ter with non­sur­gi­cal treat­ments, it may be time for carpal tun­nel release surgery.

Dur­ing carpal tun­nel release, your sur­geon will cut the lig­a­ment that con­nects your wrist and palm. This cre­ates more space inside your wrist and reduces ten­sion on the carpal tun­nel. The surgery can be open or endoscopic.

Carpal tun­nel release is usu­al­ly out­pa­tient, so you can go home the same day of the surgery. The surgery can often be done with local anes­the­sia (med­ica­tion that tem­porar­i­ly blocks pain in a small area of the body) or light seda­tion, rather than gen­er­al anes­the­sia (med­ica­tion that puts you in a sleep-like state).

Also read: What Does Gen­er­al Anes­the­sia Mean?

While it can take sev­er­al months to ful­ly heal from surgery, most peo­ple can go back to their dai­ly activ­i­ties with­in a few days. How­ev­er, your provider may rec­om­mend wait­ing four to six weeks before return­ing to more stren­u­ous activ­i­ties, like sports or intense workouts.

I Think I Have CTS, But It’s Not That Bad. Do I Still Need to See a Doctor?

Even if your symp­toms aren’t that both­er­some, it’s best to get med­ical care soon­er rather than lat­er. CTS gets worse over time, and it’s hard­er to man­age in its lat­er stages. You’re less like­ly to need surgery if you get it tak­en care of ear­ly on. Also, the irri­ta­tion in your wrist can cause per­ma­nent dam­age if it remains untreated.

Whether your symp­toms are just start­ing or they’ve become severe, CTS can be a frus­trat­ing con­di­tion. But with the right treat­ment, most peo­ple can find relief. Call today to sched­ule your carpal tun­nel eval­u­a­tion with an ortho­pe­dic specialist.