FAQs on Carpal Tunnel Syndrome (CTS) from a Phoenix Arizona Pain Management Center

Carpal tunnel syndrome (CTS) is a condition that results from problems with the wrist structures. More common in women than men, CTS is a common source of hand/finger pain and numbness.

The carpal tunnel is a narrow wrist structures formed at the bottom and sides by the carpal (wrist) bones, and at the top, covered by fibrous connective tissue (transverse carpal ligament). The median nerve passes through this tunnel in the wrist and controls the feeling on the palm side of the fingers and thumb.

What causes CTS?

Carpal tunnel syndrome is the result of tissue (synovium) swelling around the flexor tendons of the wrist, which puts pressure on the median nerve. The synovium lubricates the flexor tendons, making it easier for finger movement.

What are some risk factors for carpal tunnel syndrome?

Certain people have increased risks for CTS. These include:

Heredity – This trait often runs in families, as some people have smaller carpal tunnels than others.

Over use of hands and wrists – Over time, this causes synovium swelling.

Hormones – Hormonal changes play a key role in development of CTS.

Age – CTS risk goes up with age.

Certain medical conditions – These include rheumatoid arthritis, diabetes, and thyroid imbalance.

What are the symptoms of CTS?

The most common symptoms of CTS include an electric shock-like feeling that occurs in the fingers, strange sensations that travel up the arm, pain of the fingers, hand, and wrist, as well as numbness and tingling. These symptoms can occur any time, but are often worse at night because people often curl the wrist during sleep.

CTS symptoms also occur during the day when holding the phone or driving. The symptoms are often of gradual onset, and may come and go. With severe CTS, symptoms include clumsiness/weakness of the fingers, which makes fine motor movements difficult.

How is carpal tunnel syndrome diagnosed?

To determine if or not you have CTS, the doctor will ask you questions about your symptoms and take a detailed medical history. He/she will also conduct physical tests and order diagnostic tests, such as x-rays and electrophysiological testing.

How is CTS treated?

Carpal tunnel syndrome usually progressively gets worse without some type of treatment. However, it can be cured in the early stages if diagnosed. When symptoms arise due to a particular occupation, the patient can modify his/her activities to stop disease progression.

Bracing and splinting – To keep the wrist in a neutral position, the doctor may recommend a brace or splint. This prevents median nerve irritation, which occurs during sleep when the wrist is curled. A splint is often worn during the day to alleviate symptoms.

 

Medications – The most commonly prescribed drug class for CTS is non-steroidal anti-inflammatory drugs (NSAIDs). Ketoprofen, naproxen sodium, and ibuprofen are all in this class.

 

Corticosteroid injections – The doctor can inject the carpal tunnel with a corticosteroid agent, which offers pain relief and alleviates symptoms. Carpal tunnel steroid injection was found to reduce short-term symptoms in a recent clinical study. At two-year follow-up, local steroid injection was an effective means of treatment for CTS.

 

Surgical treatment – This is considered for severe cases of CTS. The decision to have surgery is based on the severity of the patient’s symptoms. Surgery is a choice for patients with long-standing CTS who experience wasting of the thumb muscles and constant numbness.

 

Short-wave diathermy (SWD) – This procedure was found to provide short-term relief in patients with CTS. It alleviates pain and improves hand function.

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