Dr. Sanford Hawkins-Rivers of Village Surgical Associates in Erwin, North Carolina discusses carpal tunnel syndrome and its treatments.
What is it? Carpal Tunnel Syndrome, or CTS, is a compression neuropathy of the median nerve that occurs in the carpal tunnel canal at the wrist. Tendons and the median nerve traverse this canal.
What are the Symptoms of CTS? Symptoms consist of numbness and tingling in the distribution of the median nerve. This means that the thumb, index finger and middle finger are mostly affected. Long term injury to the nerve can cause muscle atrophy of the thenar muscle group (the muscles near the thumb). With long term CTS the patient can lose grip strength and will often complain of dropping small objects.
What is the cause of CTS? By definition CTS is caused by idopathic synovitis of the flexor tendons. (swelling of the flexor tendons going to the hand) This swelling of the tendons causes pressure to be placed on the median nerve. Trauma to the wrist as well as soft tissue masses or overgrown muscles in the forearm can also give the symptoms of Carpal tunnel.
How is CTS diagnosed? CTS can be diagnosed by physical exam with a positive phalens test or durkins test. (numbness reproduced with manual compression of the nerve or numbness or pain with flexion of the wrist.) Nerve conduction studies are also very useful in diagnosing the disorder.
What is the treatment for CTS? Conservative treatment for CTS consists of anti-inflammatory medication and splinting the wrists. The anti-inflammatory medication helps reduce the swelling of the tendons at the wrist. The splinting prevents excessive bending at the wrist. Steroid injections can also be given as an anti-inflammatory agent. Conservative treatment is useful, however, as CTS is a mechanical problem, surgery and transecting the transverse carpal ligament is the definitive treatment of Carpal Tunnel syndrome.
To learn more, visit www.villagesurgical.com