How Carpal Tunnel is Treated?

Introduction

Carpal tunnel syndrome (CTS) is a common condition that affects millions of people worldwide, including a significant number in the UK. It occurs when the median nerve, which runs through the wrist’s carpal tunnel, becomes compressed or irritated. This can cause numbness, tingling, and pain in the hand and fingers, as well as weakness in the thumb. In this article, we will explore the various treatment options available for carpal tunnel syndrome, ranging from conservative management to surgical intervention.

Non-Surgical Treatment Options

Lifestyle Modifications

  • Take regular breaks: Avoid long periods of repetitive hand and wrist movements.
  • Maintain a neutral wrist position: Keep your wrist straight and avoid bending it excessively.
  • Ergonomic adjustments: Use proper posture and ergonomics when working with computers or performing other tasks that involve repetitive hand movements.

Wrist Splints

Wearing a wrist splint at night can help keep the wrist in a neutral position, reducing pressure on the median nerve. Splints can be purchased over-the-counter or custom-made by a healthcare professional.

Medications

  • Over-the-counter pain relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help alleviate pain and inflammation.
  • Prescription medication: In some cases, a doctor may prescribe stronger painkillers, such as codeine or co-codamol.

Physical Therapy

  • Range-of-motion exercises: These exercises can help improve flexibility and strength in the affected hand and wrist.
  • Nerve-gliding exercises: These can help reduce nerve compression by promoting nerve mobility.
  • Ultrasound therapy: This non-invasive treatment uses sound waves to promote blood flow and reduce inflammation.

Corticosteroid Injections

In some cases, a doctor may recommend injecting a corticosteroid, such as prednisolone, directly into the carpal tunnel. This can provide short-term relief from pain and inflammation.

Surgical Treatment Options

If non-surgical treatments do not provide adequate relief, surgery may be considered. The two primary surgical options are:

Open Carpal Tunnel Release

This traditional surgical technique involves making an incision in the palm and cutting the transverse carpal ligament to release pressure on the median nerve. The procedure is usually performed under local anaesthesia.

Endoscopic Carpal Tunnel Release

This minimally invasive technique involves inserting a small camera (endoscope) through a small incision in the wrist or palm to visualize the carpal tunnel. The surgeon then uses specialized instruments to cut the transverse carpal ligament, relieving pressure on the median nerve. This procedure may result in less post-operative pain and a quicker recovery compared to the open technique.

Post-operative Care and Rehabilitation

Following carpal tunnel surgery, patients will typically need to:

  • Wear a wrist brace or splint for a few weeks to support the wrist and promote healing.
  • Attend physical therapy sessions to regain strength and flexibility in the hand and wrist.
  • Gradually return to normal activities, avoiding excessive strain on the hand and wrist.

Treatment Outcomes for Carpal Tunnel Syndrome

Treatment Success Rate Side Effects/Risks
Lifestyle Modifications Variable Minimal, if any
Wrist Splints Variable Discomfort, skin irritation
Medications Variable Potential side effects, drug interactions
Physical Therapy Variable Minimal, if any
Corticosteroid Injections 50-70% Temporary relief, potential side effects
Endoscopic Carpal Tunnel Release 90-95% Infection, nerve damage, scarring, surgical complications
Open Carpal Tunnel Release 90-95% Infection, nerve damage, scarring, surgical complications

Preventing Carpal Tunnel Syndrome

While not all cases of carpal tunnel syndrome can be prevented, certain measures may help reduce the risk or alleviate symptoms. These include:

  1. Proper ergonomics: Arrange your workspace to promote good posture and reduce strain on your wrists and hands. For example, adjust your chair and keyboard height to maintain a neutral wrist position.
  2. Stretching and strengthening exercises: Regular hand and wrist exercises can help maintain strength and flexibility, reducing the risk of developing CTS.
  3. Avoid excessive force: Use tools and devices designed to reduce the amount of force required for tasks, such as ergonomic keyboards and power tools with vibration dampening features.
  4. Take breaks: Regularly take breaks from activities that involve repetitive hand and wrist movements to prevent overuse and strain.

When to Seek Medical Advice

If you are experiencing persistent symptoms of carpal tunnel syndrome, such as numbness, tingling, or pain in the hand and fingers, it is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment. Early intervention can help prevent permanent nerve damage and improve your overall quality of life.

Conclusion

Carpal tunnel syndrome is a prevalent condition that can significantly impact a person’s daily life. Fortunately, there are several treatment options available, ranging from lifestyle modifications and conservative therapies to surgical intervention. By seeking appropriate medical advice and following prescribed treatments, most individuals with carpal tunnel syndrome can achieve symptom relief and regain function in their affected hand and wrist.

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