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Carpal Tunnel Syndrome


What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a condition where there is increased pressure on the median nerve in the wrist. The median nerve controls muscles and feeling in the hand. Pressure may come from overuse and swelling of ligaments in the wrist.

What increases my risk for carpal tunnel syndrome?

  • Activities that require forceful or repetitive movement of your wrist and hand
  • Previous wrist injury
  • Pregnancy
  • Health conditions such as diabetes, arthritis, and hypothyroidism
  • Obesity

What are the signs and symptoms of carpal tunnel syndrome?

  • Dull, sharp, or shooting pain in your hand
  • Numbness, tingling, or a burning feeling in your thumb, first finger, and middle finger
  • Arm pain that may extend to your shoulder
  • Weakness in your hand
  • Swelling in your hand

How is carpal tunnel syndrome diagnosed?

Your caregiver will examine your hand and arm. He will ask how long you have had symptoms and what makes them worse. You may need any of the following tests:

  • Nerve compression tests: Your caregiver will tap, squeeze, press on, and gently move your wrist in different ways. These tests are used to check for pressure on your nerve.
  • X-ray: This is used to look at the bones in your wrist and hand to find the cause of your symptoms.
  • Electrodiagnostic studies: Electrodiagnostic studies may include nerve conduction studies and electromyography. These studies test how well your nerves are working. Your caregiver may use these tests to learn more about your condition and decide how to treat your symptoms. Ask for more information about these tests.
  • MRI: This scan uses powerful magnets and a computer to take pictures of your wrist and hand. An MRI may show if you have CTS. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell caregivers if you have any metal in or on your body.

How is carpal tunnel syndrome treated?

In some cases, CTS may go away without treatment. In other cases, you may need one or more of the following:

  • Medicines:
    • NSAIDs: These medicines decrease swelling and pain. NSAIDs are available without a doctor's order. Ask your caregiver which medicine is right for you and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.
    • Steroids: This injection helps decrease pain and swelling.
  • Transcutaneous electric nerve stimulation: This treatment uses mild electrical impulses to help decrease your wrist pain.
  • Surgery: Carpal tunnel decompression is surgery to take pressure off of the median nerve in your wrist.

What are the risks of carpal tunnel syndrome?

  • Steroid injections may damage your median nerve and the tissues around it. You may need more than 1 steroid injection to help decrease pain. Even after treatment, your symptoms may not go away, or they may come back. After surgery, your wrist may be sore and a scar may form. You may bleed more than expected during surgery. You may get an infection in your wrist after surgery.
  • Your CTS may get worse over time if it is not treated. The pain, numbness, tingling, or burning may get worse and last longer. Your hand and wrist may get weaker. You may have lasting nerve damage or paralysis (loss of feeling or movement) of your hand.

How can I manage my symptoms?

  • Use ice: Ice helps decrease swelling and pain in your wrist. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover the ice pack with a towel and place it on your wrist for 15 to 20 minutes every hour.
  • Rest your hands: Let your hands rest for a short time between repetitive motions, such as typing. If you feel pain, stop what you are doing and gently massage your wrist and hand.
  • Get physical and occupational therapy: Physical therapists will show you ways to exercise and strengthen your wrist. Occupational therapists will show you safe ways to use your wrist while you do your usual activities.
  • Use a wrist splint: This keeps your wrist straight or in a slightly bent position. A wrist splint decreases pressure on the median nerve by letting your wrist rest. You may need to wear the splint for up to 8 weeks. You may need to wear your wrist splint at night.
  • Evaluate your work habits: Ask about ways to modify your work to help decrease your symptoms.

When should I contact my caregiver?

Contact your caregiver if:

  • Your symptoms get worse.
  • Your hand and fingers are so weak that you cannot grab, squeeze, or lift items.
  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You suddenly lose feeling in your hand or fingers and you cannot move them.
  • Your hand suddenly changes color.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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