Carpal Tunnel Syndrom
What is it?
Carpal tunnel syndrome is caused by pressure on the median nerve. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of the hand. When the median nerve is compressed, symptoms can include numbness, tingling, and weakness in the hand and arm.

Symptoms
Carpal tunnel syndrome symptoms usually start gradually and include:
• Tingling or numbness. You may notice tingling and numbness in the fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not the little finger. You might feel a sensation like an electric shock in these fingers.
The sensation may travel from the wrist up the arm. These symptoms often occur while holding a steering wheel, phone or newspaper, or may wake you from sleep.
Many people “shake out” their hands to try to relieve their symptoms. The numb feeling may become constant over time.
• Weakness. You may experience weakness in the hand and drop objects. This may be due to the numbness in the hand or weakness of the thumb’s pinching muscles, which are also controlled by the median nerve.

Many factors can also contribute to the development of carpal tunnel syndrome. These factors can include:
• Heredity (smaller carpal tunnels can run in families).
• Pregnancy.
• Hemodialysis (a process where the blood is filtered).
• Wrist facture and dislocation.
• Hand or wrist deformity.
• Arthritic diseases such as rheumatoid arthritis and gout.
• Thyroid gland hormone imbalance (hypothyroidism).
• Diabetes.
• Alcoholism.
• A mass (tumor) in the carpal tunnel.
• Older age.
• Amyloid deposits (an abnormal protein).
Carpal tunnel syndrome is also more common in women than in men.

Surgical treatments
Surgery is recommended when carpal tunnel syndrome does not respond to non-surgical treatments or has already become severe. The goal of surgery is to increase the size of the tunnel in order to decrease the pressure on the nerves and tendons that pass through the space. This is done by cutting (releasing) the ligament that covers the carpal tunnel at the base of the palm. This ligament is called the transverse carpal ligament.
If you have surgery, you can expect to:
• Have an outpatient procedure where you will be awake, but have local anesthesia (pain numbing medication). In some cases, your doctor may offer an IV (directly into the vein) anesthetic. This option allows you to take a brief nap and wake up after the procedure is finished. This is not a general anesthetic, like what is used in surgery. Instead, your healthcare team will monitor you during the procedure (called monitored anesthetic care, or MAC). This is also used for procedures like a colonoscopy.
• Be in brief discomfort for about 24 to 72 hours after surgery. People usually experience complete nighttime symptom relief quickly—even the night after surgery.
• Have your stitches removed 10 to 14 days after surgery. Hand and wrist use for everyday activities is gradually restored by using specific exercise programs.
• Be unable to do heavier activities with the affected hand for about four to six weeks. Recovery times can vary depending on your age, general health, severity of carpal tunnel syndrome and how long you had symptoms. You will continue to gain strength and sensation in the following year after surgery.
• Have relief from most carpal tunnel syndrome symptoms.