Mayo Clinic: I have carpal tunnel syndrome that used to bother
me only at night. Wearing a splint helped, but, now, my
symptoms are noticeable throughout the day, as well. Does this
mean surgery is inevitable, or are there other things I can do
to help lessen the tingling and numbness itís causing?
Carpal tunnel syndrome is caused by pressure on the median
nerve thatís in the front of your wrist. Treatment for
carpal tunnel syndrome usually starts with splinting,
self-care measures and, if needed, a corticosteroid injection.
If that provides only temporary relief, then surgery may be
carpal tunnel is a small passageway on the palm side of your
wrist. Nine tendons and the median nerve travel through the
carpal tunnel. Those tendons are like ropes that control the
movement of your fingers. The median nerve serves as a pathway
for the sensations you feel in your palm, thumb, index finger,
middle finger and outer border of your ring finger. It also
sends the nerve signals that move muscles around the base of
tunnel syndrome happens when the space in the carpal tunnel
becomes smaller or the tendons in the tunnel thicken, placing
pressure on the median nerve. In its early stages, symptoms
may include tingling or numbness in your thumb, index finger,
middle finger and outer border of your ring finger.
splint typically is the first step in carpal tunnel treatment.
A splint can be particularly helpful for people whose symptoms
bother them at night. Wearing a splint during the night can
keep the wrist from bending while you sleep. That can relieve
the nerve pressure and eliminate nighttime discomfort.
symptoms persist during waking hours, wearing a splint during
the day can be useful. You also may be able to ease daytime
symptoms by taking frequent breaks from repetitive activities.
Throughout the day, take time to rotate your wrists, and
stretch your palms and fingers. Taking a pain reliever, such
as ibuprofen, naproxen or aspirin, may help lessen the
inflammation of carpal tunnel syndrome.
steps arenít enough, then a corticosteroid injection into
the carpal tunnel may reduce tingling and numbness.
Corticosteroids lower inflammation and swelling within the
carpal tunnel, which can relieve pressure on the median nerve.
those with severe symptoms or whose symptoms come back after
an injection, surgery may be an appropriate option. The goal
of carpal tunnel surgery is to relieve pressure on your median
nerve by cutting a ligament, called the transverse carpal
ligament, pressing on the nerve.
surgery for carpal tunnel syndrome has been performed as an
open surgery in which a surgeon makes a small incision in the
palm of the hand over the carpal tunnel and then releases the
ligament. Alternatively, this procedure can be performed via
endoscopic surgery. With that approach, the surgeon uses a
telescope-like device with a small camera attached to it,
called an endoscope, to see inside the carpal tunnel. The
surgeon cuts the ligament through one or two small incisions
in the hand or wrist.
carpal tunnel release is another alternative treatment in
which a surgeon or a qualified physician uses ultrasound
images to guide an instrument into the carpal tunnel through a
small incision in the forearm, and then cut the ligament. As
the techniques for ultrasound carpal tunnel release continue
to evolve, the procedures may be able to be performed in a
doctorís office under local anesthesia.
treating carpal tunnel syndrome as promptly as possible is
important. The longer the median nerve remains compressed, the
more damaged it can become. If the nerve is compressed for too
long, it may not recover even once the pressure is relieved.
Eventually, that could lead to permanent weakness and lack of
coordination in your fingers and thumb.