Carpal Tunnel Syndrome (CTS) is a prevalent condition resulting from pressure on the median nerve, which runs through a passage in the wrist called the carpal tunnel. This nerve is pivotal as it controls sensation and muscle impulses in the hand. The carpal tunnel itself is a narrow channel formed by wrist & carpal bones and a ligament, housing the median nerve and tendons.

When this space narrows due to thickening of the transverse carpal ligament or other factors, it compresses or “pinches” the median nerve, leading to CTS. Recognizing the role of both the carpal tunnel and the median nerve is essential in understanding the onset and management of this condition.

At Academy Orthopedics, we prioritize educating our patients about Carpal Tunnel Syndrome (CTS) to empower them with knowledge and effective treatment options. Our experienced team of orthopedic specialists is dedicated to providing comprehensive care for individuals experiencing CTS symptoms. 

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Early Signs and Symptoms of Carpal Tunnel in Hands and Wrist

Early detection of Carpal Tunnel Syndrome (CTS) is crucial for effective management. Initial signs often include tingling, numbness, or a burning sensation, primarily in the thumb, index, middle, and ring finger. As CTS progresses, patients might experience frequent nighttime discomfort, leading to disrupted sleep. The wrist pain and these sensations are directly linked to the entrapment of the median nerve.

When the nerve is compressed within the carpal tunnel, it results in these characteristic symptoms. Over time, without intervention, this can lead to significant numbness, weakened grip strength and dexterity challenges. Understanding the connection between wrist splint, pain, and median nerve entrapment can aid in early diagnosis, paving the way for timely treatment.

Carpel Tunnel Syndrome vs. Tendonitis

When confronted with wrist pain, understanding the distinction between Carpal Tunnel Syndrome and tendonitis is crucial. The key disparity lies in their respective impacts: while one affects the tendons, the other targets the nerves within your wrist. It’s imperative to recognize, however, that there can be some overlap in the symptoms of wrist tendonitis and Carpal Tunnel Syndrome. Consequently, relying on self-diagnosisis discouraged. Always seek professional evaluation for accurate identification and effective treatment.

How is Carpal Tunnel Syndrome Diagnosed and Assessed?

Carpal Tunnel Syndrome (CTS) is diagnosed and assessed through a combination of clinical evaluation, medical history review, and diagnostic tests. Here’s a more detailed breakdown of the diagnostic and assessment process:

Medical History Review: The initial step in diagnosing CTS involves discussing the patient’s medical history and symptoms. The physician will ask questions about when the symptoms started, their severity, and any factors that exacerbate or alleviate the pain and discomfort. 

Physical Examination: A physical examination is conducted to assess the patient’s hand, wrist, and arm. The physician will check for signs such as swelling, tenderness, and muscle weakness. They may also evaluate the patient’s hand strength, range of motion, sensation and the presence of Tinel’s sign and Phalen’s test.

• Tinel’s Sign: The physician gently taps on the median nerve at the wrist. A tingling or shock-like sensation in the fingers can indicate compression of the median nerve.
• Phalen’s Test: The patient is asked to flex their wrists by pressing the backs of their hands together for about a minute. Numbness or tingling during this test can suggest CTS.

Electrodiagnostic Tests: To confirm the diagnosis and assess the severity of CTS, electromyography (EMG) and nerve conduction studies (NCS) may be ordered. These tests measure the electrical activity in the muscles and the speed at which nerves transmit signals.

EMG: This test involves inserting a fine needle electrode into specific muscles in the hand and forearm. It measures muscle activity to determine if there is any muscle damage.

NCS: NCS measures the speed at which electrical signals travel through nerves. In the case of CTS, it helps identify the slowing of nerve conduction across the carpal tunnel due to compression.

Imaging Studies: In some cases, imaging studies like ultrasound or MRI (Magnetic Resonance Imaging) may be used to visualize the carpal tunnel and surrounding structures. These tests can help rule out other conditions or identify structural abnormalities contributing to CTS.

Other Considerations: Your physician will also consider other potential causes of your symptoms.

Based on the findings from these assessments, your healthcare provider will determine whether you have CTS, its severity, and the most appropriate treatment options.

Tailored Non-Surgical Approaches

Not all Carpal Tunnel Syndrome (CTS) cases require surgical intervention. In fact, many patients benefit from non-invasive treatments tailored to their unique needs. One of the most common initial approaches is night time wrist splinting, which keeps the wrist in a neutral position, alleviating pressure on the median nerve and offering relief from symptoms.

Beyond splinting, specific stretching exercises can be prescribed to the wrist and hand muscles, promoting better wrist alignment and reducing nerve compression. Furthermore, ergonomic adjustments at one’s workstation or in daily routines can have a transformative impact.

This might mean repositioning your keyboard, using ergonomic tools, or simply ensuring you take regular breaks to stretch and rest the wrist. Such lifestyle adjustments, when combined with targeted treatments, can significantly improve CTS symptoms and overall wrist health.

Empowering Surgical Interventions

For more advanced cases of Carpal Tunnel Syndrome, surgical interventions can offer long-lasting relief. The most common procedure, carpal tunnel release surgery, involves releasing the transverse carpal ligament, relieving pressure on the median nerve.

In recent years, advancements have led to minimally invasive techniques, allowing for quicker recovery and reduced post-operative pain. Such surgeries are typically considered when non-surgical treatments prove ineffective or when the nerve compression has reached a severe stage. The decision to proceed surgically is always taken after thorough consultation, ensuring that patients are empowered with knowledge and choose the best path for their health and comfort.

During the surgical procedure, the transverse carpal ligament is carefully separated to alleviate the compression on the median nerve, subsequently increasing the size of the carpal tunnel.

In the conventional surgical approach, an incision of approximately 2 inches is made in the palm and wrist region. Alternatively, endoscopic surgery employs one or two incisions of about half an inch each, along with the utilization of an endoscope for visualization. Furthermore, advancements in medical techniques now permit carpal tunnel syndrome surgery to be conducted using minimally invasive methods, often with local anesthesia alone. Your surgeon will make a decision about the most suitable approach for you, considering both your overall health and medical circumstances.

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Complications Arising from Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) can lead to various complications if left untreated or improperly managed. These complications can significantly impact hand function and overall quality of life. Some of the potential complications arising from Carpal Tunnel Syndrome include:

Nerve Damage: Prolonged compression of the median nerve within the carpal tunnel can lead to permanent nerve damage. This may result in persistent numbness, weakness, and loss of coordination in the affected hand and fingers.

Muscle Atrophy: Severe cases of CTS can lead to muscle atrophy (wasting) in the hand. This occurs when the muscles receive reduced nerve signals due to the compression of the median nerve. Muscle atrophy can weaken the hand and limit its ability to perform fine motor tasks.

Chronic Pain: If Carpal Tunnel Syndrome is not properly managed, it can lead to chronic pain in the wrist, hand, and fingers. The persistent discomfort can interfere with daily activities, sleep, and overall well-being.

Loss of Hand Function: As CTS progresses, the affected hand may lose dexterity and strength. This can make it difficult to perform routine tasks such as gripping objects, typing, and buttoning clothes.

Functional Limitations: Compromised hand function can limit a person’s ability to work and engage in hobbies or recreational activities. Individuals may find it challenging to participate in activities they once enjoyed.

Sleep Disturbances: Numerous individuals afflicted with CTS often endure carpal tunnel syndrome symptoms such as nocturnal numbness and pain. These symptoms can significantly disrupt sleep patterns, leading to sleep disturbances and heightened fatigue.

It’s important to note that early diagnosis and appropriate treatment can help prevent these complications from worsening. If you suspect you have Carpal Tunnel Syndrome or are experiencing symptoms, seeking medical attention and discussing treatment options with a healthcare professional is crucial to prevent potential complications.

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Comprehensive Care for Carpal Tunnel Syndrome at Academy Orthopedics

Whether you’re experiencing the early signs of CTS or seeking guidance on managing its complications, we’re here to help. Our comprehensive approach includes accurate diagnosis, non-surgical interventions, and if necessary, minimally invasive surgical options. We prioritize your well-being, aiming to enhance your quality of life and restore hand function. 

Don’t let Carpal Tunnel Syndrome hold you back from enjoying life to the fullest. Contact Academy Orthopedics today to embark on your journey toward relief and lasting support. Your hands deserve the best care, and our Board Certified hand specialist, Dr. Jonathan Katz is here to get you back to being your best.