Carpal tunnel syndrome (CTS) is one of the most common problems in the wrist that I see in Family Medicine. It can range from being annoying to downright disabling. Although it’s quite common, many people aren’t familiar with what it is or its many treatment options.
What is Carpal Tunnel Syndrome (CTS)?
Carpals are little bones that are part of your wrist joint. The carpal tunnel is a tunnel for tendons and nerves to travel from your forearm to your hand.
The nerve involved in carpal tunnel syndrome is called the median nerve. In CTS, this nerve is under pressure as it travels through the tunnel. When nerves are under too much pressure, you can experience tingling, burning, pins and needles, or numbness along the nerve’s path. Sometimes, you can experience pain, but in CTS this is less likely.
If the condition goes on for too long (we’re talking years), then the signal that the median nerve carries to the muscles can be impeded. In advanced cases of CTS, this is what causes the muscles in the hand to shrink and become weaker. That’s why it’s important to get treatment early for this condition.
I suspect CTS if I see a patient with pins and needles/numbness in their thumb, index and middle fingers that’s been going on for a while. I suspect it even more in pregnant people, since pregnancy means more fluid in the body, which in turn puts more pressure on the nerve in the finite space of the carpal tunnel.
Carpal Tunnel Syndrome Treatment
In Family Medicine, we like to use a step-wise approach when it comes to treatment. We start with the most effective treatments that are the least invasive with the lowest risk of side effects, and then move to more invasive/riskier treatments if a patient isn’t getting better.
Take breaks
Many people with CTS have symptoms when they do repetitive tasks with their hands for hours at a time. This can be typing, knitting, playing video games, or writing, just to name a few examples. The first step to treatment I recommend is to take breaks during activities that flare symptoms. If your fingers start to go numb after an hour of typing away at the computer, take a break for a few minutes every half hour.
Night brace
The next step to treatment is to try a brace at night. Symptoms of CTS often wake people up at night, and a brace can help. I recommend going to an allied healthcare provider like a physiotherapist or occupational therapist who can help with fitting a brace for you.
I don’t usually recommend using a brace during the day for CTS. This can cause more problems than it solves: braces can be uncomfortable to wear, limit movement in the hands, limit hand washing (especially problematic at this time of year with all the viruses going around), and are usually not needed during waking hours.
Injections/Procedures
If symptoms are persistent and severe, steroid injections are an effective option for CTS. They’ve been shown to help symptoms and to put off surgery for this condition.
The last option that’s used to treat carpal tunnel syndrome is surgery. This has come a long way in recent years. Microsurgery can now be done to treat CTS, which is where the surgery is done in an office instead of an operating room, and patients can use their hand again the same day.
Carpal Tunnel Syndrome in Pregnancy
When I was pregnant, I had months of carpal tunnel syndrome in both hands. It mostly bothered me night, adding to the number of symptoms I had in pregnancy that kept me awake.
CTS happens in pregnancy because the body has more fluid on board, which leads to more fluid pressing on the median nerve within the carpal tunnel. Thankfully, the condition usually gets better after pregnancy. In the meantime, taking breaks and using night splints are good options.
I hope this helps, and let me know what condition you want to learn more about!
Disclaimer: My posts are for education and guidance only. The information in them should only ever be used alongside the advice from a primary care provider or qualified healthcare professional.
The reference I used for this post about carpal tunnel syndrome can be found here.
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