Every year a significant number of patients see a physician complaining of hand numbness, tingling and pain. Many of these patients are assumed to have nerve compression in the neck area and come to the doctor’s office with an MRI of the cervical spine. Some may even have had surgery performed in the neck area with little or no relief. The reason the pain persists may be because they have been given the wrong diagnosis.
What they might really be experiencing is known as Carpal Tunnel Syndrome (CTS), caused by compression of the median nerve at the wrist. The carpal tunnel is a pathway made of ligaments creating a tunnel through which the nerve travels. In addition to the median nerve, tendons also travel alongside the nerve. If the carpal tunnel becomes narrowed for any reason, this will cause compression on the nerve and tendons. For example, if any of the ligaments forming the tunnel get swollen, inflamed or thickened, this will limit the space available for the nerve and tendons to go through and the person may become symptomatic. It is commonly considered to be an occupational condition due to repetitive movements at the wrist.
What are the symptoms associated with Carpal Tunnel Syndrome?
At the beginning, a feeling of numbness and /or tingling in the hands is a very common symptom of CTS. Patients often complain that this sensation wakes them up at night. The symptoms are improved by shaking their hands or hanging them over the side of the bed. Others report dropping things or having trouble opening jars or making a fist. When patients wait too long to seek treatment, they can develop muscle loss in the hands with weakness of the thumb.
There are several ways to diagnose CTS:
The Neurosurgeon will initially evaluate the patient by getting a medical history and conducting a physical exam. If CTS is suspected, an electromyogram and nerve conduction velocities test will be done to confirm the diagnosis.
What is the course of treatment?
If CTS is caught early enough, treatment with a wrist splint or a course of hand therapy may be all that is necessary. For those patients that have not responded to non-operative measures, outpatient surgery may be required. The goal of surgery is to relieve the pressure on the nerve by cutting the tissues responsible for the compression, thereby opening the carpal tunnel. The operation is performed on an outpatient basis under sedation or nerve block and usually takes no longer than 10 minutes.
The risks are minimal. The recovery time is short and the success rate is excellent as long as the procedure is performed before permanent nerve damage has occurred. If you or someone you know suffers from pain possibly related to CTS, please call Neurospinal Associates to set up an appointment for an evaluation.
Neurospinal Associates offers two convenient locations to serve their patients. In Bradenton, they are located in the Riverwalk Professional Park at 200 3rd Avenue West, Suite 200, directly west of the Manatee Memorial Hospital and just North of the Bradenton Herald. Their Sun City location is at 3909 Galen Court, Suite 104. For more information, or to schedule an appointment, please call 941-794-3118 or contact us.
