Carpal Tunnel Syndrome: Minimally Invasive Endoscopic Carpal Tunnel Release
Edited By: Thomas Trumble, M.D.
Last updated Wednesday, October 11, 2006
Figure 4 - Rest and bracing provides the best relief. Review of the conditionWhat are some general characteristics of carpal tunnel syndrome? What are its usual manifestations? Carpal tunnel syndrome (CTS) is a condition in which the median
nerve is compressed so that the patients experience numbness, pain and
occasionally weakness. The nighttime numbness often causes
the patient to wake up and shake their hand. CTS usually progresses
slowly over time but the rate varies widely. When the patient has
to flex their wrist for an activity, i.e. holding a steering wheel or
hair dryer, numbness can occur.What are the different types of carpal tunnel syndrome? Carpal tunnel syndrome can be mild, moderate or severe. Mild CTS is
often causes intermittent numbness. In moderate CTS the symptoms cause
frequent nighttime wakening. In severe CTS, the patients often notice
weakness and they can drop objects without realizing it.What else might be confused with or similar to carpal tunnel syndrome? How can these be distinguished from the condition? Sometimes a pinched nerve in the neck (cervical radiculopathy) can cause hand numbness and the electrical test (EMG/NCV) can determine
if this is present. Hand arthritis can cause hand pain but should not
cause hand numbness.How common is carpal tunnel syndrome (statistics, demographics, risk factors)? CTS is very common with the peak incidence at age 55. Although both men
and women can develop CTS, the condition is more common in women than
in men.How is carpal tunnel syndrome diagnosed? What tests or exams may be used? CTS is diagnosed by the patients history, physical examination and
electrical diagnostic studies (EMG/NCV). The history of nighttime
numbness, combined with an examination of tenderness over the wrist
(Tinel's sign) and increase numbness with wrist flexion (Phalen's sign)
help to make the diagnosis. In the Tinel's test, tapping the wrist
often produces electrical like sensations going into the fingertips.
The EMG/NCV is a test performed by a neurologist or physiatrist that
measure the speed of nerve conduction. When there is pressure on
the nerve the conduction speed significantly decreases.Can medications help carpal tunnel syndrome? Braces worn at night can be very helpful by decreasing the nighttime
numbness and helping the patients sleep. Nonsteriodal anti-inflammatory drugs (NSAIDs) like ibuprofen can help to relieve the
symptoms but they do not provide a cure. These medications can be
helpful for short-term use but most patients usually do not take
these medications on a chronic basis for their CTS because there can be
side effects associated with chronic NSAID use.Can exercises help carpal tunnel syndrome? Exercises generally do not help because they increase the swelling
around the nerve. Rest and bracing provides the best relief. (Figure 4)Specifically, how is carpal tunnel syndrome improved by endoscopic carpal tunnel syndrome? Endoscopic carpal tunnel release (endo-CTR) releases the pressure on the nerve and restores its normal blood supply. Studies of endo-CTR have demonstrated that patients generally regain their original strength with significant improvement in their symptoms <sup>4</sup> <sup>3</sup>Therapy after surgery can help the patients reduce scar formation and increase their strength. The patients at home usually do these exercises. The patients can return to nearly all activities within several weeks. By three months, studies have shown that the patients have recovered to a point where there was no difference in sensation and strength when the hand with CTS was compared to the other hand that had no symptoms.
Surgery for carpal tunnel syndrome at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4537 to make an appointment.
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