What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome refers to a condition wherein there is a compression of the median nerve at the carpal tunnel which is located in the palm side of the wrist. The symptoms are often described as tingling, sharp, and shooting pain extending from the wrist into the fingers. There is also numbness that travels along the index and the middle three fingers and occasionally the thumb. Factors that increase the risk for having carpal tunnel syndrome include obesity, thyroid disorders, repetitive use syndromes, occupational and idiopathic. The diagnosis is often made within the exclusion of radicular pain coming from the neck.
A detailed history and physical, imaging studies especially MRI of the wrist, and probably most importantly electrodiagnostic studies to differentiate carpal tunnel syndrome versus cervical radiculitis from a herniated disc. Treatment options depend on any identifiable cause. Often though, correction of hormonal imbalances does not result in a decrease in symptoms but rather can prevent worsening of the condition. Physical therapy, including the use of wrist splints, and range of motion exercises can all help. Further treatment with acupuncture and manual occupational therapy, can be tried before consideration is given to injections. Carpal tunnel injections can be effective, especially when done under ultrasound image guidance. The decision for surgery is a failure of conservative treatment, especially if there is a recurrence of symptoms shortly after successful injections.
