Carpal Tunnel Syndrome: Causes and Surgical Treatment

Published on January 20, 2017

Carpal tunnel syndrome (CTC) is a medical condition resulting from a pinched nerve in the wrist. The median nerve runs through the carpal tunnel. The carpal tunnel, also called the carpal canal, is a narrow passageway that connects your forearm to your hand. It is located on your wrist’s palm side. CTC occurs as a result of compression of the median nerve due to underlying health problems, your wrist’s anatomy, or the same wrist movements made constantly over a long period of time.

The movement and the feeling in your first three fingers and your thumb are controlled by the median nerve. Swelling or any other medical problems can make the carpal tunnel smaller. This will put pressure on the median nerve. The main symptoms of CTC include a tingling sensation, numbness, and pain in the three fingers and the thumb. If you have problems with all your fingers except your little finger, then it may a sign that you have CTC.

What Causes CTC?

A number of factors can cause the swelling that leads to the compression of the carpal tunnel. This includes conditions like rheumatoid arthritis, diabetes, and hypothyroidism; trauma; and making the same wrist movements over and over for a long period of time. CTC is associated with any medical condition that causes pressure on the median nerve.

Obesity is another reason why you may have CTC. Genetics (smaller than normal carpal tunnel size) play a role as well. Extrinsic factors such as vascular malformation, ganglion, and lipomas can lead to CTC. In these cases, pressure on the carpal tunnel is exerted from the outside.

Work-related factors include repetitive tasks, posture, force, and vibration. OSHA (Occupational Safety and Health Administration) has rules regarding cumulative trauma disorders. In many places, workers identified with CTC are entitled to time off and compensation. The relationship between CTC and work, however, is still a controversial subject.

The hormonal changes and the water retention that are common during pregnancy can lead to CTC as well.

Surgical Treatment

Surgery is recommended to treat CTC when all the other treatments, such as home treatment, physical therapy, and reduction of inflammation with non-steroidal anti-inflammatory drugs, fail. Also, if you have had CTC for a very long time, if the nerve is damaged, or if there is a risk of damage to the nerve, then you will have to come in for surgery. The surgery is usually done under general anesthesia. The surgeon will carefully cut the ligament that’s exerting pressure on the nerve.

There are two types of surgery: endoscopic surgery and open surgery. In endoscopic surgery, only one or two incisions are made on the wrist or in your hand. The surgeon will insert an endoscope to see the inside of the carpal tunnel and then will cut the ligament. Open surgery involves your surgeon making a larger incision in the palm for greater access and visibility and then cutting the ligament to relieve pressure on the median nerve.

The healing process involves the ligament tissues slowly growing back normally, with adequate room for the median nerve to function properly. You will have to avoid any strenuous activity with your treated hand for some time. The soreness and the weakness that you may feel after the surgery will vanish after some time.

In the United States, about 5% of people have CTC. The best way to decrease the risk of developing CTC is to be physically active.

Find Out More During a Consultation

If you’re seeking treatment for your carpal tunnel syndrome, there’s no better option than Dr. Lawrence Glassman. Dr. Glassman is an experienced board-certified plastic surgeon with numerous satisfied patients. Contact our office today to schedule an informative consultation.

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