Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) describes a constellation of symptoms that results from increased pressure in the bony canal in the wrist containing a motor sensory nerve. The carpal tunnel is comprised of the carpal bones and fibrous ligaments. Nine flexor tendons that flexed the fingers and connect them to the large flexor muscles in the form travel through the carpal tunnel. The only nontendon structure the travel to the carpal tunnel is the median nerve. Increased pressure due to increased tendon activity can increase the pressure in this finite space overtime. The result is pain and/or weakness in the hand from median nerve compression. The most commonly described symptoms are numbness and tingling and weakness of the grip.  If diagnosed early CTS can be treated with complete resolution of symptoms.  Alternatively long standing CTS can lead to irrevesible muscle loss and nerve damage. 

The diagnosis is made by certain findings on history and physical examination. Electromyographic and nerve conduction studies can be used to confirm the diagnosis.

Treatment should be offered on a continuum based on severity of symptoms and potential for resolution of the problem. Extension wrist bracing, physical therapy and anti-inflammatory therapy are among the non-operative modalities available. Surgical release/ decompression of the carpal tunnel can be done both open or endoscopic when appropriate.

We would be happy to discuss all of the options. For an appointment contact the office. The main office is located at 11 Peekskill Hollow Road in Putnam Valley, New York and the office number is 845 – 526 – 2080.

The carpal tunnel is actually a part of your body. It’s a narrow channel at the wrist level that is composed of the carpal bones and transverse carpal ligament. Through this narrow channel travels nine tendons connecting forearm muscles to the fingers that they flex, and a large motor sensory nerve responsible for thumb motion and sensation of one half of your hand. With repetitive motion and or flexion at the wrist these tendons swell and exert pressure in this narrow tunnel on the sensory nerve. The result of this pressure is a misinterpretation of information between the fingertips and the brain. Patients report often numbness and tingling, intolerance to hot and cold temperatures, aching in the forearm, severe pain in the hand often causing arousal from sleep.

Overtime, carpal tunnel syndrome can cause loss of fine motor control of the fingers and muscular atrophy of the muscles leading to loss of strength in your grip. These changes are sometimes irreversible. There are other conditions that can masquerade as a carpal tunnel syndrome. In fact compression of nerves that supply the extremity in the neck can lead to similar symptoms. Some autoimmune conditions can also produce similar symptoms. Fortunately, nerve conduction studies can help your doctor distinguish between these conditions.

It had only been a brief two hours after she had fallen asleep for the night when she was awoken from sleep with pain in her left hand. This is been going on for months, and seems to be affecting her performance during the day at work. During her appointment I confirmed for suspicion after a brief clinical exam reviewing her nerve conduction studies she had carpal tunnel syndrome.

Fortunately, my patient was happy to learn about the variety of nonoperative effective therapies for her problem. After a few minor interventions she was symptom free. She now enjoys full nights rest, and is more productive at work the following day.