Carpal tunnel syndrome is one of the most common conditions treated by hand surgeons.

Symptoms include numbness and tingling in the hands, cramping or burning, or pain that travels all the way up the arm. Often people with carpal tunnel syndrome will wake up at night with these symptoms.

Causes of carpal tunnel syndrome

“Many factors can contribute to developing carpal tunnel syndrome including genetics, metabolic diseases like diabetes and thyroid disorders, obesity and prolonged vibrational activity,” said Salem Health hand surgeon Jeffrey Knight. “While anyone at about any age can develop carpal tunnel syndrome, it is more common in women and increases in likelihood after age 40.”

Knight said it was historically suggested that repetitive work activity was associated with the development of carpal tunnel syndrome, but this was disproven and generally is not the underlying cause. However, work activity can worsen symptoms, and activity that involves prolonged vibration to the hands and wrist can cause carpal tunnel syndrome.

What is the carpal tunnel?

The carpal tunnel is formed by the arch of the wrist bones in the back of the wrist and a ligament across the front in the palm and wrist.

“The median nerve and tendons that flex the fingers pass through this space. Swelling within the carpal tunnel causes pinching of the nerve,” Knight said.

Prolonged or repeated pressure on the nerve, because of swelling or positioning, causes abnormal signals through the nerve, leading to pain and numbness.

The hand surgeon can diagnose people facing these symptoms with a physical exam and nerve studies can help determine severity.

Treatment options

“Early on, carpal tunnel symptoms may respond to such treatments as rest, anti-inflammatory medications or vitamin B6 supplements, therapeutic stretching techniques and using wrist splints to keep the wrist in a straight position,” Knight said.

Cortisone injections can also be used to calm swelling and improve symptoms. The next step is surgery to reverse pressure on the nerve, but patients can also be candidates for surgery without ever having an injection.

“Surgery involves cutting the ligament that forms the roof of the carpal tunnel to create more space for the nerve and reverse the pressure and pinching of the nerve,” Knight said.

It often brings complete relief.

“When properly diagnosed, surgery for carpal tunnel syndrome has a very high success rate for complete recovery.”

The hand surgeon noted if a surgery is not performed in time, symptoms can become irreversible. In that case, surgery may not provide complete relief.

“This usually only happens if there is constant numbness that never goes away as well as significant hand weakness before surgery,” Knight said.

Knight said it generally takes a week or two for the wound to heal after surgery, and patients should feel back to normal in about a month. Activities like driving or typing can be done almost immediately after surgery.

Hand surgery at Salem Health

Do you think carpal tunnel surgery is right for you? Salem Health Orthopedics has the largest group of surgeons in the mid-Willamette Valley specifically trained in treatment of hand and wrist conditions.  

Knight said a year ago it was taking two to three weeks to get an appointment to see a provider. Now, with the addition of two more physician associates, there are often openings the same day.

Click here to learn more about care with Salem Health Orthopedics.