Some people with CTS say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night. The dominant hand is usually affected first and produces the most severe symptoms. As symptoms worsen, people might feel tingling during the day, especially with certain activities such as talking on the phone, reading a book or newspaper, or driving. Hand weakness may make it difficult to grasp small objects or perform other manual tasks.
Some people with very severe CTS cannot determine between hot and cold by touch, and may burn their fingertips without knowing it. Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture; an overactive pituitary gland; an underactive thyroid gland; and rheumatoid arthritis.
Other factors that may contribute to the compression include mechanical problems in the wrist joint, repeated use of vibrating hand tools, fluid retention during pregnancy or menopause, or the development of a cyst or tumor in the canal. Often, no single cause can be identified. Women are three times more likely than men to develop carpal tunnel syndrome. CTS usually occurs only in adults.
Workplace factors may contribute to existing pressure on or damage to the median nerve. The risk of developing CTS is not confined to people in a single industry or job, but may be more reported in those performing assembly line work—such as manufacturing, sewing, finishing, cleaning, and meatpacking—than it is among data-entry personnel. Treatments for carpal tunnel syndrome should begin as early as possible, under a doctor's direction. Underlying causes such as diabetes or arthritis should be treated first.
Carpal tunnel release is one of the most common surgical procedures in the United States. Generally, surgery involves severing a ligament around the wrist to reduce pressure on the median nerve. Surgery is usually done under local or regional anesthesia involving some sedation and does not require an overnight hospital stay.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Carpal tunnel syndrome fact sheet. National Institute of Neurological Disorders and Stroke.
Accessed Nov. Carpal tunnel syndrome. American Academy of Orthopaedic Surgeons. Kothari MJ. Clinical manifestations and diagnosis of carpal tunnel syndrome. Etiology of carpal tunnel syndrome. Spagnolo F, et al. Journal of Clinical Oncology. Yung M, et al. Journal of Occupational and Environmental Hygiene.
Amadio PC expert opinion. Mayo Clinic. Treatment of carpal tunnel syndrome. Hunter AA, et al. Surgery for carpal tunnel syndrome. Mayo Clinic; Riggin EA. Allscripts EPSi. Shiri R, et al. Computer use and carpal tunnel syndrome: A meta-analysis. Alternative non-surgical therapies like yoga, acupuncture, massage, etc. Common surgical treatment for CTS usually involves the severing of the ligament around the wrist to alleviate pressure on the median nerve.
Physicians usually use open release surgery or endoscopic surgery to achieve this goal. Open release surgery is typically done under local anesthesia, and it involves making an incision of approximately two inches in the wrist to severe the carpal ligament and enlarge the carpal tunnel. Endoscopic surgery, on the other hand, has faster recovery time and minimal post-op discomfort than the open release surgery.
However, it comes with a higher risk of complications. The tube also has a knife that the physician uses to nick the carpal ligament. The surgical severing of the carpal ligament relieves the pressure on the median nerve, and during recovery, the ligament can regrow. Post-operative recovery for CTS treatment usually takes several months to one to two years.
Grip and pinch strength may not improve to functional conditions for three to six months. Timeline for recovery usually depends on several factors including the continuation of post-surgical therapy, the absence of nerve damage, and infection at surgical sites.
Carpal Tunnel or Carpal Tunnel Syndrome CTS can be prevented by adopting safe ergonomic measures such as proper posture, stretching, and reducing or avoiding prolonged repetitive activities. Workers should take breaks following overuse of hand. Employers should incorporate workstations that enable workers to work in safe, natural positions. Citations 1. Carpal Tunnel Syndrome Fact Sheet.
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