The phrase carpal tunnel may conjure images of a rideshare road structure, but this anatomical region is not, in fact, a carpool tunnel. The analogy works, though. Located at the wrist on the palm side, the carpal tunnel is an actual tunnel through which nine flexor tendons and the median nerve pass. Similar to our hypothetical riders, these tissues travel from forearm to hand to perform important jobs, such as giving feeling and movement to the fingers. And when pinched in a traffic jam, as with carpal tunnel syndrome, those HOV occupants get pretty inflamed. To better understand this common condition, we asked Roper St. Francis Healthcare orthopedic hand surgeon Dr. Kimberly Young to ride along on our discussion of why CTS occurs and how it can be treated.
Could it be Carpal Tunnel Syndrome?
“Carpal tunnel syndrome develops because there’s not enough room in the tunnel,” explains Dr. Young. This can happen when the flexor tendons swell or the transverse carpal ligament (tunnel roof) thickens from overuse or when the bones at the base of the tunnel narrow due to arthritis. “While the tendons can tolerate getting squished, the nerves cannot.” The result can be weakness or clumsiness in the hand, a pins-and-needles sensation in the fingers or burning pain in the fingers or forearm, especially at night.
Dr. Young frequently sees CTS in patients who sleep in the fetal position with their wrist curled or who regularly use high-vibration tools (think weed wackers, lawnmowers and construction equipment). The condition can also arise from gripping the steering wheel on long car trips or using poor ergonomics at a desk, though computer positioning as a cause for the condition is still heavily debated.
CTS impacts about five percent of adults, with three times as many women as men diagnosed. “The theory holds that their carpal tunnels are smaller, so things get squished more easily,” explains Dr. Young. Pregnancy, obesity and genetics can also put a person at risk.
Treating Carpal Tunnel Syndrome
When symptoms first appear, sleeping with a wrist brace to avoid that curled up position may help. Dr. Young also recommends stretching your hands frequently when performing repetitive manual tasks and taking extensive breaks from high-vibration tools. If those preventive measures don’t remedy the problem, steroid injections may be used early on, though these aren’t as effective once the condition has advanced. If symptoms persist, a quick outpatient surgery can open the tunnel. “The hand will be in a dressing for three days but can be used for light activities right away,” assures the doctor.
However, left untreated, CTS could damage the nerve beyond repair, causing permanent weakness or loss of feeling in the hand. If numbness and tingling wake you at night or cause clumsiness in your thumb and fingers, make an appointment with our orthopedic team.