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  • Carpal Tunnel Syndrome

    Carpal tunnel syndrome refers to the compression of the median nerve in the wrist. The median nerve passes through a small tunnel in the wrist that can become inflamed and irritated, thus resulting in the numbness and tingling into the hand and fingers. The severity of the symptoms can be determined by performing a nerve conduction test in the office. The treatments are generally non-surgical, using nonsteroidal medications, wrist splints, therapy, and occasional injections into the carpal canal.

    One of the most common causes of carpal tunnel syndrome is the repetitive use of the wrists or hands, such as when using a computer keyboard. Often, the repetitive nature of a job cannot be avoided; however, applying appropriate ergonomics can certainly help to reduce the risk of developing carpal tunnel syndrome.

    One of the most common complaints of patients with carpal tunnel syndrome is numbness and/or tingling in the wrists and hands, usually into the thumb and index fingers. Often there is pain which sometimes radiates into the elbow or shoulder. X-rays of the wrists are usually normal, so the diagnosis relies more on a clinical presentation and electrodiagnostic testing.

    A thorough work up also needs to eliminate the cervical spine as the cause of the symptoms. A disc lesion in the neck can compress one of the nerve roots and cause numbness and tingling into the fingers. Sometimes, an MRI may reveal a cervical lesion which is contributing to the symptoms. The most helpfull diagnostic test to delineate between median nerve compression in the wrist and a cervical radiculopathy, is the EMG/Nerve Conduction Study. The EMG/NCS demonstrates any nerve damage, and aids in the selection of surgical cases.

    Once the diagnosis of carpal tunnel syndrome is made, the treatment is usually non-surgical. Nonsteroidal antiinflammatory medication, carpal tunnel splints, wrist exercises, and occasionally injections usually will suffice. If pain persists, surgery may be the ultimate treatment.

    Carpal Tunnel Syndrome

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