Integrated Approach to Treat Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is the most common hand problem treated by Loyola Medicine’s experienced hand surgeons. Loyola’s doctors use an integrated approach to care, combining the expertise of orthopaedic specialists and occupational therapists who focus on hand and wrist therapy.
The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of your hand. The median nerve runs through this tunnel from your forearm into your palm; when it’s pressed or squeezed at the wrist, it can lead to numbness, weakness or pain. You may feel a burning, tingling or itching feeling in your palm or fingers.
If you have persistent symptoms of carpal tunnel syndrome, or if it keeps you from sleeping or doing your everyday activities, make an appointment to see a Loyola orthopaedic specialist. Leaving the condition untreated can lead to permanent nerve and muscle damage.
Why Choose Loyola for Treatment of Carpal Tunnel Syndrome?
Loyola’s occupational therapists have extensive experience in education and workplace modifications to prevent carpal tunnel syndrome. By addressing the cause of the problem, many people are able to avoid symptoms from occurring and patients with mild symptoms frequently find relief.
Loyola’s orthopaedic team includes specialists trained in caring for hand and wrist conditions, including carpal tunnel syndrome. In addition, Loyola’s occupational and physical therapists have expertise in developing individualized treatment plans to help you return to normal activities.
How is Carpal Tunnel Syndrome Diagnosed?
Carpal tunnel syndrome is caused by pressure on the median nerve and tendons in the carpal tunnel. It is often the result of a repetitive strain injury. Some people have a hereditary predisposition to the problem.
Trauma or injury to the wrist, arthritis, obesity, thyroid problems, diabetes and work stress may contribute as well. It is more common in women than men and usually develops first in the dominant hand.
To diagnose carpal tunnel syndrome, your Loyola doctor will talk with you about your symptoms and medical history, in addition to conducting a thorough physical exam that may include:
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Bending and holding your wrists in certain positions to check for numbness or a tingling sensation (Phalen test)
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Checking for weakness in muscles around the base of your thumb, or a weak hand grip
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Tapping over the median nerve to see if it causes pain (Tinel sign)
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Testing your sensation by tapping on the fingertips while your eyes are closed
Your doctor may order additional tests, including an electromyogram (EMG), nerve conduction velocity and wrist X-rays.
How is Carpal Tunnel Syndrome Treated?
Several non-invasive and non-surgical treatments are available for carpal tunnel syndrome, including:
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Anti-inflammatory drugs, including ibuprofen
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Corticosteroid injections
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Stretching and strengthening exercises
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Warm and cold compresses
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Wearing a splint at night
Frequently, changes to your workplace—like specially made keyboards, keyboard drawers or computer mouse—can reduce the stress on your wrist.
If these options do not work and symptoms last for six months, carpal tunnel release surgery may be recommended by your Loyola surgeon. This procedure consists of making a two-inch incision on the wrist and cutting into the ligament that is pressing on the median nerve, which improves pain and function. The procedure is usually performed under local anesthesia.
Loyola’s orthopaedic surgeons also are able to perform carpal tunnel release surgery endoscopically. In this minimally invasive procedure, two small incisions are made and the surgery is completed using a telescope-like device with a tiny camera attached to it. This surgery usually results in less pain than open surgery.
