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Carpal Tunnel: A Look Inside

Have you experienced numbness or tingling in your fingers that takes a while to resolve after waking up in the morning? Or sharp pain in your hand, wrist or forearm after using your hand for an extended period of time? You could be dealing with Carpal Tunnel Syndrome (CTS).

CTS occurs when the median nerve is compressed in the tunnel on the palm side of the wrist and hand. The tunnel is surrounded by the bones of the wrist (carpal bones) and the transverse carpal ligament. This narrow opening contains nine tendons and one nerve that course from your wrist through the tunnel and into your hand. Pressure on the hand, inflammation, arthritic changes, and swelling can decrease the space in the tunnel, causing nerve compression.

When the nerve gets compressed, several signs and symptoms may occur including:

•Numbness and tingling in the fingers

•Pain in the hand, wrist or forearm

•Weakness in the hand resulting in dropping of small objects

•Impaired sensation and difficulty with fine motor coordination (buttoning, turning a key)

Scheduling an appointment with a Hand Surgeon is the best way to receive a diagnosis. They can determine if you have CTS with a thorough history of your symptoms and a series of manual tests that detect compression of the median nerve. Sometimes your doctor may order an EMG depending on the severity of your symptoms.

Your doctor may refer you to a Certified Hand Therapist for treatment. Your therapist will perform a formal evaluation to assess your mobility, strength, and sensation to determine an appropriate treatment plan.

Some treatment recommendations include:

•Use of a wrist brace at night

•Exercises for mobility, strength, and coordination

•Activity modifications to limit nerve compression

•Instruct on body mechanics while completing activities of daily living

Most patients will respond well to therapy; however, some patients may continue to experience symptoms after a bout of therapy. For those who continue to experience symptoms, there is a surgery that can be done to relieve compression off the nerve. Recover ranges from 2-6 weeks on average and you may be referred to a hand therapist after surgery.

*Image provided by the American Society of Hand Therapists

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