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Carpal tunnel syndrome

Carpel tunnel syndrome is the compression of the median nerve which runs from the arm to the hand through the carpal tunnel. The median nerve controls the muscles around the base of the thumb. The tendons that bend the fingers and thumb, called flexor tendons, also travel through the carpal tunnel. When the median nerve is pinched or compressed, numbness, tingling, and pain can occur in the arm and hand. There are a wide range of causes of carpal tunnel syndrome, including: anatomical issues (small wrists), heredity, certain inflammatory conditions, pregnancy and its related hormonal imbalances, diabetes, rheumatoid arthritis, thyroid gland imbalance, age, and repetitive movement such as operating a jackhammer.

Endoscopic surgery offers relief to patients suffering from severe carpal tunnel syndrome. This is one of the most common procedures performed by BMC's orthopedic hand surgeons.

Diagnosing Carpal Tunnel Syndrome

Physical Exam

Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.

Electromyography (EMG)

A single-fiber electromyography measures the electrical energy traveling between the brain and muscles.

Nerve Conduction Study

A nerve conduction study measures how well and how fast the nerves can send electrical signals.

X-Rays

A form of electromagnetic radiation with very high frequency and energy. X-rays are used to examine and make images of things such as the bones and organs inside the body.

Ultrasound

Diagnostic ultrasound, also called sonography or diagnostic medical sonography, is an imaging method that uses high-frequency sound waves to produce images of structures within the body. The images can provide valuable information for diagnosing and treating a variety of diseases and conditions. Most ultrasound examinations are done using a sonar device outside the body, though some ultrasound examinations involve placing a device inside the body.

MRI

This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be injected with a contrast agent for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than x-ray and ultrasound and for certain organs or areas of the body, it provides better images than CT. MRI may not be recommended if you have a pacemaker or other metal implants.

Blood Tests

A common tool for disease screening, blood tests provide information about many substances in the body, such as blood cells, hormones, minerals, and proteins.

Treatments for Carpal Tunnel Syndrome

Bracing / Splinting

A splint, also known as a brace, is a rigid device that holds a body part in place so that it is unable to move. It is usually used as a treatment for a suspected fracture, sprain/ligament damage, or other injury. It can be applied by first responders in the event of trauma. Splints can reduce pain, aid in proper healing, and can also prevent further injury. They can be worn for several days or weeks to hold the body part in place for the duration of healing time.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A class of medications, including but not limited to aspirin, naproxen, and ibuprofen, that are used for reducing pain and redness, swelling, and heat (inflammation) in arthritis and other painful inflammatory disorders.

Activity Modification

Physicians may prescribe general lifestyle changes to a patient, in order to help relieve the symptoms of their condition and improve their overall physical function and well-being. Depending on the medical condition being treated, activity modification may include: decreasing or increasing one's level of physical activity; added rest; beginning a new activity or exercise program; changing sleep habits; or modifying one's physical environment at home, in their vehicle, or at work.

Corticosteroid injections

Also known as cortisone shots, these are injections that may help relieve pain and inflammation in a specific area of the body. Cortisone shots are most commonly given into joints — such as the ankle, elbow, hip, knee, shoulder, spine, and wrist.

Carpal Tunnel Release Surgery

Carpal tunnel release surgery is performed to decompress the median nerve at the level of carpal tunnel (wrist). There are two main types of carpal tunnel surgery: open and endoscopic. Both are outpatient procedures. Most carpal tunnel surgeries are performed using the "open" technique, which involves a 1-2 inch incision in the palm. Endoscopic carpal tunnel release surgery can be performed under regional or general anesthesia and is sometimes associated with less pain and faster recovery.

Physical Therapy

Sometimes referred to simply as "PT," this is a type of rehabilitative treatment that uses specially designed exercises and equipment to help patients preserve, regain, or improve their physical abilities following injury, disability, disease, or surgery. Physical therapy can include therapeutic exercise, massage, assistive devices, and patient education and training.

Occupational Therapy

Sometimes referred to simply as "OT," this is a type of therapy that focuses on engagement in meaningful activities of daily life (as self-care skills, education, housework, or social interaction). The goal of occupational therapy is to enable or encourage participation in these everyday activities despite a patient's physical or mental challenges.

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