Carpal Tunnel Syndrome Frequently Asked Questions

The carpal tunnel is a narrow channel on the palm side of the wrist. Eight bones, called carpals, form an arch creating three rigid walls of the channel. A tight, broad band of tissue, called the transverse carpal ligament, covers the arch and forms a roof over the channel. This “tunnel” is the protective passage for the median nerve and all nine tendons that bend the fingers and thumb. Click here for more information.
Carpal tunnel syndrome, or CTS, is caused by pressure or pinching of the median nerve as it passes through the carpal tunnel on its way to the palm of the hand. The tunnel is a rigid, confined space, so any inflammation or swelling in the tunnel can compress the median nerve. This leads to weak and poorly functioning hand muscles. Click here for more information.
The first symptom is usually numbness or tingling in the thumb, index finger, long finger, and ring finger. Patients may notice their grip weakening. Because of the weakened grip, patients frequently complain about dropping objects. Although pain is a less common symptom, the content numbness can feel painful. A persistent ache, particularly in the thumb, may spread up to the shoulder, the neck, or both. In severe cases, there may be a constant burning pain in the wrist and hand. Click here for more information.
A diagnosis of carpal tunnel syndrome is made after a physician will take the patient’s history, perform a physical examination, and manual tests, including Phalen’s Maneuver, Tinel’s Sign, Electrodiagnostic Studies, a nerve condition study, and Electromyography. Click here for more information.
Treatment of carpal tunnel syndrome should begin conservatively by isolating the wrist with the use of a splint, oral anti-inflammatory medication, and avoiding the activities that cause the irritation. Steroid injections are a possibility. Click here for more information.
There are two popular surgical techniques used in the operative treatment of carpal tunnel syndrome., the open technique and the endoscopic technique. Both of these techniques have relatively high success rates; approximately 90% of patients get relief from their symptoms. There are advantages and risks associated with each method. The preferred procedure depends on the surgeon’s experience and should only be selected after the options have been discussed in detail. Click here for more information.
Complications from non-operative treatment of carpal tunnel syndrome are few and rare. Taking antiinflammatory medication may cause the patient to experience an upset stomach, or possibly develop an ulcer. The only significant risks are associated with the steroid injection, and these are small. Click here for more information.
There are possible complications from surgical treatment, but they are relatively rare. There are risks associated with anesthesia, infection, and possible injury to nerves, vessels, or tendons. Other potential problems following surgery include finger stiffness, a tender scar, persistent numbness, and (rarely) increased pain. Click here for more information.
With non-operative treatment, symptoms can subside in a few days, but more commonly, relief may take as long as several weeks or months. Treatment continues as long as the symptoms seem to improve and they do not interfere with daily activities. Click here for more information.
Following surgery the hand will be bandaged, often in a splint, and kept elevated, while keeping sutures clean and dry for seven to fourteen days, followed by removal. Patients often notice improvement in symptoms with days after the surgery. A hand therapist will prescribe exercise and improvement may occur gradually over several weeks or months. Click here for more information.