Health Watch: Are you suffering from Carpal Tunnel Syndrome?

Carpal tunnel syndrome is very common, affecting three million Americans each year.  With 27 bones (plus a network of nerves and tendons), the hand is a complex structure, making it highly susceptible to injuries and other medical problems such as carpal tunnel syndrome.  But how do you know if you are suffering from carpal tunnel syndrome?

Dr. Kyle Xu, SLUCare plastic, hand and microsurgeon says carpal tunnel syndrome can take away the most basic abilities from a patient's hands like buttoning shirts, opening jars, typing.  It's time to look into treatment, "When the numbness gets so bad, they start dropping things because they can't feel their fingers."

SLUCare’s hand surgeons at SSM Health St. Louis University Hospital now offer two options to release carpal tunnel and provide relief.

The median nerve is the largest nerve of the arm, providing feeling to the thumb, index, long and ring fingers. If this nerve becomes compressed at the wrist, you may experience numbness and pain in the fingers that may wake you up at night or limit use of your hand. Other nerves in the arm can also become compressed, limiting arm use.  Dr. Xu says, "If the nerve is so damaged, the weakness may be lifelong or it may not improve."

Previously, it was assumed that carpal tunnel syndrome was caused by an overuse injury or a repetitive motion performed by the wrist or hand, often at work. We now know that it’s most likely a congenital predisposition (something that runs in families) – some people simply have smaller carpal tunnels than others. Carpal tunnel syndrome can also be caused by injury, such as a sprain or fracture, or repetitive use of a vibrating tool. It's also been linked to pregnancy, diabetes, thyroid disease, and rheumatoid arthritis.

Patients can wear a hand brace for at least six weeks.  If that does not help Dr. Xu says, "usually, I do one steroid injection. And if it recurs, then we will go to surgery.”

Carpal tunnel release surgery may be necessary if 1) nonsurgical interventions for carpal tunnel syndrome don’t relieve the pain; 2) the muscles of the hands or wrists are weak and actually getting smaller because of the severe pinching of the median nerve; 3) the symptoms have lasted 6 months or longer with no relief.

Carpal tunnel release is an outpatient procedure. There are 2 types of carpal tunnel release surgery: 1) open release, in which the surgeon cuts open the wrist to do the surgery, and 2) endoscopic carpal tunnel release, where a thin, flexible tube that contains a camera is put into the wrist through a tiny incision. The camera guides the doctor as the surgery is done with thin tools put into the wrist through another small cut.  Dr. Xu uses small tools to open the wrist and release the pinched nerves.  "I think the open carpal tunnel surgery is great because it works. It's been done for hundreds of years and it definitely works."

Or, he can insert a tiny camera to help release the nerve from the inside. "Endoscopic carpal tunnel surgery, the nice thing about it is patients do have less pain and they can return to work sooner."

Recovery takes anywhere from several weeks to months depending on how long the nerve was compressed. Studies suggest it has a clinical success rate of 75 to 90%.

To learn more or to book an appointment with SLUCare's Hand Surgeons, click here.

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