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Carpal Tunnel Syndrome

According to the American Association of Neurological Surgeons, carpal tunnel syndrome (CTS) is a common problem affecting hand function, caused by compression of the median nerve at the wrist. It most often occurs when the median nerve in the wrist becomes inflamed after being aggravated by repetitive movements, such as typing on a computer keyboard, talking on the phone (holding phone to the ear), texting or playing the piano.

The carpal tunnel is formed by the bones, tendons and ligaments that surround the median nerve. Since the median nerve supplies sensation to the thumb, index, and middle finger and part of the ring finger (digits one through four), and provides motion to the muscles of the thumb and hand, CTS may cause numbness, pain and weakness in these areas.

Common Symptoms

  • Hand and wrist pain.
  • A burning sensation in the middle and index fingers.
  • Thumb and finger numbness.
  • An electric-like shock through the wrist and hand.

The numbness or pain may be worse at night, and may actually keep you awake. During the day, it may occur more often when participating in activities that require you to bend the wrist (talking on the phone, driving).

Before treatment can begin, a thorough evaluation is necessary. Treatment may include medication and/or bracing or physical therapy. If none of these treatments provides relief, your doctor may recommend surgery to correct the problem.

The most common procedure is called carpal tunnel release, which can be performed using an open incision or endoscopic techniques.

The open incision procedure involves the surgeon opening the wrist and cutting the ligament at the bottom of the wrist to relieve pressure. The endoscopic procedure involves smaller incision(s), using a miniaturized camera to assist in viewing the carpal tunnel. The possibility of nerve injury is slightly higher with endoscopic surgery, but the patient’s recovery and return to work may be quicker.

The Providence Medical Center neurosurgeons perform carpal tunnel surgery.