Carpal Tunnel Syndrome: Treatment Options

Carpal tunnel syndrome (CTS) is a well-known condition that affects many people. The two most common questions about carpal tunnel syndrome are what it is and how can it be treated?

What is carpal tunnel syndrome?
Carpal tunnel syndrome is characterized by unusual feelings, called paresthesias, in a fairly specific area of the hand.  It results from an irritation of the median nerve in the wrist region, as the nerve passes through a bony “tunnel” created by the carpal bones of the wrist.  Patients with CTS typically experience the following sensations in their thumb and fingers:

• numbness
• tingling 
• burning
• “electric shocks”
• “pins and needles” 

In addition, patients often have difficulty gripping and pinching objects. Many patients report dropping things and “fumbling” while trying to button, tie and manipulate small objects, like jewelry clasps.

How is carpal tunnel syndrome treated?
If a doctor/therapist suspects CTS, he or she will usually prescribe a simple wrist support, or splint, for up to six weeks.  At Good Shepherd, we also recommend performing Tendon Gliding Exercises (TGEs) and Median Nerve Gliding Exercises (MNGEs), as studies have shown reduced symptoms with these simple wrist and finger exercises. 

If splinting and range of motion exercises do not help resolve symptoms, the doctor may order a special nerve test, or EMG, to see how the nerve is functioning.  This test is well tolerated and gives the doctors an excellent assessment of the function of the nerve. 

If test results indicate impairment, an injection of anti-inflammatory steroid/pain medicine can often provide some relief.  If the symptoms fade or improve with the injection, patients are usually advised to continue using caution as they resume heavier tasks. They should continue to use their splint to avoid awkward wrist postures, which could re-irritate the nerve.

In some cases, therapy may be recommended before or after EMG testing. During therapy sessions, we help patients learn proper wrist and finger postures, as well as teach wrist and finger exercises. Sometimes, therapeutic ultrasound can be effective to reduce symptoms by alleviating some of the inflammation and swelling in the wrist/nerve area. 

If the splinting, therapy and injection fail and the patient feels he or she cannot live with the pain, carpal tunnel surgery, or carpal tunnel release, is often recommended. After surgery, patients are often “back to normal” after eight to ten weeks - sometimes a bit quicker with therapy. 

If you think you may have carpal tunnel syndrome, talk with your doctor. Be ready to give a good history of your hand issues, so he or she can make the best, most accurate diagnosis.