Symptoms and Treatment of Carpal Tunnel Syndrome
By Dr. Kevin Knox, OSMS Hand Surgeon

Dr. Kevin Knox is a board-certified, plastics fellowship-trained hand surgeon. He is seeing patients at our Fox Valley clinic. Request an appointment with him here.

Do you frequently find yourself waking up with numbness and tingling, sometimes even pain, in your fingers until you shake them out before going back to sleep?  Have you noticed difficulty buttoning a shirt, putting in earrings, or picking up pills off a table because of a lack of sensation in your fingertips?

You might be experiencing these all too common symptoms as the result of carpal tunnel syndrome, and they may be affecting the quality of your sleep and ability to perform your daily activities much more than you realize.  But you say, “I don’t type that much, how could I have carpal tunnel syndrome?”

The truth is that most people who develop carpal tunnel syndrome don’t type that much. In fact, no study has ever linked the use of a keyboard to the development of carpal tunnel syndrome despite what we have all been told by society about the link between the two.  The actual cause is not well understood; however, it is believed to be related to multiple factors with a genetic predisposition playing a large role.

Carpal Tunnel Syndrome Progression

Early Symptoms

Diagram of hand anatomy (below)

Image courtesy of orthoinfo.org

One of the difficulties with carpal tunnel syndrome is its relatively slow and benign onset.  At the beginning, symptoms are minimal, tend to come and go, and are usually easily tolerated.  Over time, left untreated, thee symptoms tend to progress and become more constant, but at a relatively slow rate.

Because the day-to-day change is so small, it is difficult to notice; however, patients tend to alter the way they use their hands, and in some cases avoid certain activities altogether without even realizing they are doing so.  I often compare it to gaining weight. One day your pants no longer fit, but that weight gain didn’t just happen since yesterday; it has been a slow process over time that escaped your attention.

Progression of Symptoms

After this initial period of slow progression, which can last years, the symptoms begin to accelerate at a faster rate resulting in increased pain frequently extending all the way to the shoulder and neck, frequent night time symptoms, weakness, and in some cases muscle atrophy in the hand.  Left untreated, long enough irreversible changes to the nerve can occur.

Carpal Tunnel Syndrome Treatment

Fortunately, treatment is much more successful and typically much easier than most people think and often does not require surgery.  There are three well established methods of treatment for carpal tunnel syndrome:

1. Splinting

Nighttime splinting is curative for about one third of patients.  It is the least invasive option and a good starting point for patients with mild symptoms.

2. Steroid Injection

For patients who symptoms require more than a splint a steroid injection is often a good choice, providing symptom relief for seven out of 10 patients.  Thus injection can be performed in the office and there are no restrictions on use of the hand following the injection.  Results from injections are usually seen withing 3 to 5 days following the injection.

Diagram of hand anatomy

Image courtesy of orthoinfo.org

3. Surgery

Of course, surgical release of the carpal tunnel is the most direct, predictable, and long lasting option, but is not required for all patients with carpal tunnel syndrome. Most surgeries can be done either under local anesthesia or light sedation, per the patient’s preference, and can be done in about six minutes.  Those patients who choose local anesthesia can even drive themselves home after surgery.

Your hand is not immobilized after surgery, in fact, you are encouraged to use your hand with a five-pound weight limit until two weeks after surgery when you return to normal use.

I remember talking to a surgeon friend of mine who had me release both his carpal tunnels. He returned to performing surgery a week after his procedure and said “My hands feel better, but what I am happiest about is I just had my first dream in 30 years because I was able to sleep through the night without my hands repeatedly waking me up!”

If these symptoms sound like what you or someone you know is experiencing, I welcome you to come see me to discuss your symptoms and come up with the appropriate treatment options.

Dr. Kevin Knox is seeing patients at our Fox Valley clinic. Request an appointment with him by clicking here.