Carpal tunnel syndrome – the most common hand ailment

The carpal tunnel is a space within the palm of your hand; within that, there is a nerve that supplies sensation to four of your fingers, not including your pinky, called the median nerve. When the transverse carpal ligament, which overlies the carpal tunnel, compresses the nerve, you get nerve irritation which results in a tingling, numbing, burning or cramping pain in those fingers, resulting in carpal tunnel syndrome. Dr. Christine Yin, assistant professor in the Michael E. DeBakey Department of Surgery, explains more about this syndrome, one of the most common hand ailments.

Who is at risk?

Carpal tunnel syndrome is prevalent in desk workers, people who do repetitive hand motions and those who keep their hands in an extended, upright position.

There are three stages of carpal tunnel syndrome: mild, moderate and severe.

“Mild is when you sometimes feel those tingling or burning sensations after activity; you can shake your hands, and then you’re okay. Moderate, you feel it a little bit more, and severe, you have this feeling all the time,” Yin said.

For those with mild and moderate carpal tunnel syndrome, Yin recommends options where you can modify your activity.

“When you’re typing, raise your desk so that you aren’t placing pressure on the nerve in your hands, modify your posture or wear a wrist brace. A keyboard pad can also help, as would an ergonomic mouse. A wrist brace is also effective at night because we tend to sleep with our hands bent or curled. The brace helps keep your wrist in a neutral position and can help alleviate symptoms,” she said.

Only surgery can help in severe cases. Surgery will alleviate some of the pressure on the nerve and give it a chance to recover.

Surgery options

There are two options for carpal tunnel surgery.

“You can open the palm and cut the ligament so that the space is bigger for the nerve. The ligament will open up, eventually fill in, and grow into a bigger carpal canal,” Yin said. “This procedure involves stitches that usually need to be taken out. Recovery includes a month off from heavy lifting or any other strenuous activity involving your hand.”

There is also a minimally invasive way – the endoscopic carpel tunnel release method.

“I make a tiny incision in the wrist, about one centimeter. I take a camera in the carpal canal to look at the ligament from the underside and cut it from the underside. With this surgery, my patients don’t have to deal with the incision on the weight-bearing part of their palm,” Yin said. “In two days, they can take off their gauze dressing, wash their hands and do everything normally. Recovery is a lot easier. With this procedure, people can return to work and activity faster; less wound care is involved.”

When to see a physician

If the pain in your hand bothers you to the point where you can’t make it through the day, if it is interfering with your life or if the tingling in your hands wakes you out of your sleep, see a physician. If carpal tunnel syndrome symptoms go unchecked, you can have muscle atrophy, which is the irreversible loss of strength in the small muscles of your hand that are responsible for fine movement.

“We use our hands daily, whether caring for ourselves, others or doing our jobs. If the pain in your hands is getting in the way of you living the life you want, see someone about it,” Yin said.

By Taylor Barnes