Carpal Tunnel Syndrome: Who’s at Risk, and How is It Treated?

Dr. Michael PensakBy: Michael Pensak, M.D.

Carpal Tunnel Syndrome (CTS) is a compression neuropathy involving the median nerve at the wrist. A compression neuropathy is essentially a pinched nerve that results from the buildup of pressure within the carpal tunnel. There are numerous causes of CTS, including swelling around the tissues in your wrist (tenosynovitis), fractures or dislocations and even pregnancy. Other common risk factors for the condition include: diabetes mellitus, thyroid disorders or rheumatoid arthritis.

Individuals with CTS may present with a constellation of symptoms including pain, numbness, tingling and they may have a tendency to drop things. Many people note that symptoms are worse at night and that their symptoms wake them up from sleep. Others report that certain activities like talking on the phone, combing their hair, or driving bring on the symptoms. A detailed history and physical exam are standard parts of the office visit when trying to establish a diagnosis of CTS. X-rays may be obtained to look for arthritis or other associated conditions. An electrodiagnostic study is usually ordered to confirm the diagnosis and evaluate its severity.

The first line of treatment for CTS is usually conservative and involves avoiding activities that provoke the symptoms, wearing a splint to keep your wrist straight, and occasionally an injection of steroids into the carpal tunnel to reduce swelling. When non-operative interventions fail an outpatient Carpal Tunnel Release (CTR) surgical procedure is recommended to prevent further damage to the nerve from the excessive pressure. Depending on the severity of your CTS, it may take several months for symptoms to go away after surgery. Recovery also involves splinting your wrist and occasionally getting occupational therapy to strengthen and heal the wrist and hand.

If you feel you are suffering from symptoms consistent with CTS, please do not hesitate to discuss with your physician or make an appointment with an orthopedic specialist.

Dr. Pensak is a fellowship trained hand and upper extremity surgeon and is a member of the Hand Center, part of the Human Motion Institute at Raritan Bay Medical Center, a member of the Hackensack Meridian Health family. He focuses on the treatment of an array of hand, wrist and elbow conditions including compression neuropathies, fractures/dislocations, tendon and nerve injuries and arthritis. Dr. Pensak’s office is located in Suite 310, 2 Hospital Plaza, Old Bridge. To make an appointment, call the Institute at 855-5-MOTION (855-566-8466).

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