How to Cope with Carpal Tunnel Syndrome

If you spend a lot of time typing at your computer or manipulating your phone, you may have encountered numbness, tingling or weakness in your hands. These symptoms are usually the calling cards of carpal tunnel syndrome, a condition in which the nerve that controls most of your hand is compressed.

Carpal tunnel syndrome is the most common nerve disorder in the world. This condition affects from 4 to 10 million Americans or, in other words, from 2.7 to 5.8 percent of the U.S. adult population. Although this condition may result from obesity, arthritis or pregnancy, it is most commonly associated with repetitive motions.

What Causes Carpal Tunnel Syndrome

In order to understand what causes carpal tunnel syndrome, you must first understand the anatomy of your arms and hands. The median nerve, which controls your thumb and four of your fingers, runs from your forearm to your digits. It passes through the carpal tunnel—a narrow passage in the wrist surrounded by ligaments, tendons and bones.

If the tendons in the carpal tunnel become irritated, they may swell and press on the median nerve. In most circumstances, merely rest is enough to remedy the condition, but in extreme cases, it may be necessary to surgically widen the carpal tunnel.

Diagnosing Carpal Tunnel Syndrome

Carpal tunnel syndrome usually first appears as a burning, tingling or numbness in the fingers or palm of the hand. Many people describe it as swelling in the fingers without any visual evidence of actual swelling. These sensations are most likely to appear at night, and patients may wake with a need to “shake out” the hands. It may be difficult to tell the difference between hot and cold.

If you visit a doctor, she will begin by performing a physical examination of the hands, arms, neck and shoulders. If the condition is primarily limited to the hands, this can rule out some similar conditions like arthritis, fractures or diabetic neuropathy. Your doctor may also recommend an x-ray or ultrasound imaging of the hands and wrists. In some cases, your doctor may recommend a nerve conduction test to determine if a nerve is slowed.

Self-care for Carpal Tunnel Syndrome

If your carpal tunnel syndrome is the result of a repetitive motion, then there are some steps your doctor may ask you to take before she attempts a more aggressive therapy. Many of these you can complete on your own, with minimal need for medical intervention, which is why these are usually the first treatment options.

  • Give your hands a break—if you are performing the same task constantly like typing or working business machinery, start taking breaks regularly every 15 or 20 minutes. This should help relieve the strain on your wrists and limit the chances that your carpal tunnel syndrome will flare up again.
  • Workout your wrists—there are some exercises that can help your carpal tunnel syndrome.
    • Shake—just relax your forearms and hands and shake them out to improve circulation
    • Stop sign—form a fist then slowly unroll your fingers until they are pointing directly up and you are forming a “stop” gesture.
    • Fan out—initially make a fist, then gently stretch out your fingers as far apart as possible.
    • Thumb touches—touch each finger to your thumb one at a time.
    • Wrist stretches—with your forearms parallel to the floor, bend your hand with your fingers pointed to the ceiling. Hold for five seconds, then repeat with your fingers pointed to the floor.
    • Wrist curl—hold a one-pound weight in the palm of your hand with your forearm extended parallel to the floor. Then bend your hand up like you are trying to touch your knuckles to your wrist.
    • Grip squeezes—squeeze a soft rubber ball and hold for five seconds. Repeat 10 times in each hand.
  • Brace your wrist—wearing a wrist brace can help keep your wrist in a neutral position and reduce strain on the joint. You should wear the brace whenever you are repeating a similar motion and at night when your wrists flex during sleep.
  • Mix up your routine—if you find yourself constantly performing the same tasks with your hands, try including new tasks that allow you to minimize wrist strain for at least part of your day.
  • OTC medications—if the discomfort is too much, you may want to consider using over-the-counter drugs like ibuprofen or naproxen.  These drugs help relieve inflammation as well as pain, so they help alleviate many carpal tunnel syndrome symptoms. You should discuss all of your medications with your doctor beforehand to avoid any cross reactions and side effects.

Major Carpal Tunnel Syndrome Treatments

If your carpal tunnel syndrome does not respond to more conservative therapies, then your physician may recommend a surgical option.  The most common surgical procedure performed in the U.S. is a carpal tunnel release which can alleviate the pain and nerve symptoms associated with this condition. A carpal tunnel release involves severing one of the ligaments in the wrist which should relieve pressure on the median nerve.

In the traditional carpal tunnel release procedure, a 2-inch incision is made that allows the surgeon to use a scalpel to cut the carpal ligament.  However, an endoscopic version of this procedure is also available which requires one or two half-inch incisions. The endoscopic procedure involves less post-operative pain and recovery time, but there is a higher risk of complications.

After the surgery, the carpal ligament does grow back together, but usually the carpal tunnel is enlarged. Although the symptoms of carpal tunnel syndrome may disappear almost immediately following the procedure, but you will likely also experience a decline in grip strength due to the severed carpal ligament. It may take many months for the ligament to heal and recover the lost grip strength.

You should not wait too long to get the surgery as prolonged compression of the median nerve can lead to permanent weakness and numbness in the fingers.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information.