Lately I have been experiencing numbness and tingling in my hands. Sometimes I am even woken up at night with hand pain. Could I have carpal tunnel syndrome?
Carpal tunnel syndrome is compression of the median nerve at the wrist. It is the most common hand problem, affecting millions of people around the world. One common symptom of carpal tunnel syndrome is pain at night. Often patients feel they have to shake their hands to get the feeling back. Many pateints also have numbness and tingling that is worse with common activities such as driving, holding a phone, reading a newspaper, or using a computer. Symptoms are often intermittent at first, becoming more constant over time.
The diagnosis of carpal tunnel syndrome is made on physical exam. Often, a nerve conduction test (electromyogram or EMG) is performed to see how severe the nerve compression is. Treatment of carpal tunnel syndrome often starts with nonoperative measures. Wearing wrist splints at night can prevent flexion of the wrist, which aggravates symptoms causing patients to wake up. In addition, nonsteroidal anti-inflammatory medications can decrease the symptoms. Occasionally patients benefit from corticosteroid injections into the carpal tunnel.
When these treatments are no longer working or when the carpal tunnel syndrome is severe, carpal tunnel release is often recommended. A small incision is made in the palm of the hand at the wrist. A ligament over the compressed nerve is released giving the nerve more room to recover. The pain at night is often relieved the same day, and the numbness and tingling improves in time. In my practice, patients go home the same day with a small soft dressing. They can use their hands immediately, needing only to protect the incision and refrain from lifting heavy objects. Patients typically need pain medication for a day or two. The dressing is removed in four days, after which time the patient can shower normally. By the time I see patients in the office two weeks after the procedure, almost everyone has excellent relief of their symptoms.
Carpal tunnel syndrome can be very debilitating, but treatment is extremely safe and effective. As a hand surgeon, this is the most common problem I treat. Often patients are so happy with the results, they wish they had come to see me earlier.
David Mikolyzk. M.D, is a fellowship trained hand and wrist surgeon at HFM Lakeshore Orthopaedics. To make an appointment, call us at (920) 320-5241.