Carpal Tunnel Syndrome

The carpal tunnel is a passageway through the wrist carrying tendons and one of the hand's major nerves. Pressure may build up within the tunnel because of disease (such as rheumatoid arthritis), injury and fluid retention during pregnancy. Carpal tunnel syndrome (CTS) develops when the pressure causes a tingling sensation in the hand, often accompanied by numbness, aching and impaired hand function.

The Center for Plastic and Reconstructive Surgery offers surgical procedures for carpal tunnel syndrome. Surgeons use leading-edge technology and world-class surgical techniques.

Nonsurgical Treatments

Splints

Conservative treatment consists of wearing a wrist splint and possibly cortisone injections. Splints can improve CTS by holding the wrist in a natural position. Night and occupational (job-specific) splints specially crafted by occupational therapists to fit the individual's hand keep the wrist in a neutral position, reducing pressure on the median nerve. Other helpful strategies include altering sleep position and avoiding extreme flexion and extension of the wrist.

Drugs

In special circumstances, various medications can ease the pain and swelling associated with carpal tunnel syndrome. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and other nonprescription pain relievers, may ease symptoms that have been present for a short time or have been caused by strenuous activity. Oral diuretics can decrease swelling.

Corticosteroids (e.g., prednisone or lidocaine) injected directly into the wrist or in pill form, can relieve pressure on the median nerve and provide immediate, temporary relief to persons with mild or intermittent symptoms. People with diabetes and those who may be predisposed to diabetes should note that use of corticosteroids could make regulating insulin levels difficult. Corticosterioids should not be taken without a doctor's prescription.

Some studies also suggest that vitamin B6 supplements may ease the symptoms of carpal tunnel syndrome.

Surgical Treatments

Carpal tunnel release is one of the most common surgical procedures in the United States. Generally recommended if symptoms are present for six months, surgery involves a two-inch incision in the wrist and cutting the carpal ligament to enlarge the carpal tunnel, reducing pressure on the median nerve. Surgery is performed under local anesthesia and does not require an overnight hospital stay. The scar gradually fades and becomes barely visible.

The results of the surgery depend in part on how long the condition has existed and how much damage has been done to the nerve. For that reason, you should see a doctor early if you think you may have carpal tunnel syndrome.

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