Keeping Carpal Tunnel Syndrome at Bay
Carpal tunnel syndrome may, if left untreated, progress from an uncomfortable tingling in the hands to a potentially debilitating condition.
Carpal tunnel syndrome refers to a compression or pinching of the median nerve—which travels from the neck through the fingers—that causes numbness and tingling in the hands and is usually worse at night and when the hands are elevated.
Houston Methodist Baytown Hospital orthopedic surgeon, Jennifer Wagner, M.D., a specialist in surgeries of the hands and upper extremities, says while it is known that carpal tunnel syndrome is caused by compression of the median nerve at the wrist, it is not always clear why certain patients develop the condition and others do not.
“There are several things that may contribute to the condition, including repetitive activities of the wrist and hands,” Wagner said. “It is more common in diabetics and people with thyroid issues or connective tissue disorders. Obesity is also known to be a factor.”
Studies indicate roughly five percent of the U.S. population suffers from some degree of carpal tunnel syndrome, while surgical treatment of the condition is the most frequent surgery of the hand and wrist, with about 500,000 such procedures performed each year. The condition affects a wide variety of people, including those who spend hours daily typing on a keyboard, mechanics, musicians, landscapers and anyone whose hobby involves repeated, meticulous hand or wrist movements.
“It may feel initially like the hand is falling asleep and you need to shake your hand out or hang it over the side of the bed. If this is happening, you should see your physician,” Wagner said.
The first step in diagnosing the condition is to perform an examination of the median nerve, which is housed in the carpal tunnel—a narrow, rigid passageway of ligament and bones at the base of the hand. The first line of treatment is a wrist brace to prevent the joint from being involuntarily flexed while the person sleeps. In many cases, that is the only action needed. But if braces do not relieve the symptoms, Wagner performs a nerve study to determine the presence of any serious conditions.
Often, injecting steroidal medicine into the carpal tunnel relieves symptoms, but surgery may also be needed. Left untreated, the condition may lead to permanent nerve damage.
Surgical options include endoscopic procedures in which a tube containing a tiny camera is inserted into the area to observe the median nerve, ligaments and tendons. The carpal ligament may be cut to relieve pressure. Wagner specializes in what’s called the mini-open procedure.
“The procedure allows me to look directly at the nerve so I can make sure there is nothing pinching on it. It allows for a small incision of just three stitches,” Wagner said. “The procedure also provides for a shorter recovery time than the traditional open surgery that has a very large incision.”
Wagner says she allows patients to perform mild activities, such as eating, getting dressed and light typing, immediately after the surgery, but patients should avoid lifting anything heavier than five pounds for about a month.
To help prevent carpal tunnel syndrome, Wagner suggests using keyboard pads to keep the wrist in a neutral position; using the entire hand—not just the fingers—to hold objects, and switching hands often when performing repetitive movements.
To schedule an appointment with a Houston Methodist Baytown Hospital orthopedic specialist, visit houstonmethodist.org/baytown or call 281.427.7400.
About Houston Methodist Baytown Hospital
Houston Methodist Baytown Hospital has provided Baytown and east Harris, Liberty and Chambers counties with quality medical care since opening its doors in 1948. The hospital has grown throughout the years with the community, providing comprehensive care at all stages of life. As a health care leader, the hospital is proud to have a fully integrated residency program focused on educating and inspiring future practitioners. Today, Houston Methodist Baytown provides some of the most advanced and innovative procedures while never wavering from its focus on compassionate and patient-centered care. Houstonmethodist.org/baytown.