Carpal Tunnel Syndrome (CTS) is one of the most commonly reported upper extremity problems in the United States, and one of the most common ailments we treat here at our Parham Rd office in Richmond. Typical symptoms of Carpal Tunnel Syndrome include nighttime numbness and pain, numbness while driving or talking on the phone. The problem arises when swelling pinches the median nerve, which provides sensation to the palm side of the thumb, index finger, middle finger and to the inside half of the ring finger. The median nerve also provides strength to the thumb muscles.
The resulting symptoms are often described as numbness, weakness and pain in the fingers, thumb, palm or the forearm. If the condition is not treated, permanent deterioration of the muscle and nerve can occur.
Most experts believe that typing does not cause Carpal Tunnel Syndrome. Some known conditions associated with CTS include a low thyroid hormone level, diabetes, obesity, and lack of aerobic fitness. Smoking is also an increased risk factor in this condition.
Carpal Tunnel Treatment
We base our diagnosis on an evaluation of your medical history, physical exam and nerve conduction testing. Initial treatment can involve rest, splinting and steroid injection. Sometimes an x-ray of the hand and wrist may be taken. Hand therapy has not been shown to have much benefit in improving the symptoms of Carpal Tunnel Syndrome. When patients are unable to get relief from the CTS symptoms by non-surgical means, surgical treatment sometimes becomes necessary.
Fortunately, most patients can undergo endoscopic surgery through a very limited incision and relatively rapid recovery. Most of the time we use skin glue to close the incision so no stitches need to be removed. The endoscope divides the tight ligament that restricts the nerve. Once the ligament is divided the nerve has more room and is no longer under pressure. The surgery is typically done under regional or general anesthesia on an outpatient basis.
There is no cast after surgery, just a soft bandage that is removed after 48 hours. Light activities such as eating, dressing and using the bathroom commence immediately after surgery. Keyboarding and heavier gripping and lifting are allowed after a few weeks. It is very rare to need hand therapy after this type of surgery. Patients are given a sheet of exercises that they start after 2 weeks. If you are in need of treatment for Carpal Tunnel Syndrome and are in Richmond, VA or the surrounding areas, please contact Dr. Desai to set up an appointment.