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CARPAL TUNNEL SYNDROME

(MEDIAN NERVE ENTRAPMENT)
Carpal Tunnel Syndrome

WHAT YOU NEED TO KNOW:

What is carpal tunnel syndrome (CTS)? CTS is a condition that causes pressure to build in the carpal tunnel. The carpal tunnel is a small area between bones and tissues in your wrist. Swelling in this area puts pressure on the median nerve. The median nerve controls muscles and feeling in the hand.


What increases my risk for CTS?

  • Activities that use forceful or repetitive movement of your wrist and hand

  • A past or current wrist injury

  • Pregnancy

  • A health condition, such as diabetes, arthritis, or hypothyroidism

  • Obesity

What are the signs and symptoms of CTS?

  • Dull, sharp, or shooting pain in your hand

  • Numbness, tingling, or a burning feeling in your thumb, first finger, and middle finger

  • Arm pain that may extend to your shoulder

  • Weakness in your hand

  • Swelling in your hand

  • Not being able to control how your hand moves, or you drop objects

How is CTS diagnosed? Your healthcare provider will examine your hand and arm. He will ask how long you have had symptoms and what makes them worse. You may need any of the following:

  • Tests may be done to check for pressure on your nerve or to test how well your nerves are working. Your healthcare provider will tap, squeeze, press on, and gently move your wrist in different ways.

  • X-ray or MRI pictures may be used to look at the bones in your wrist and hand to find the cause of your symptoms. You may be given contrast liquid to help your wrist show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell healthcare providers if you have any metal in or on your body.

How is CTS treated? Your symptoms may get better without treatment. You may need any of the following if your symptoms continue or are severe:

  • NSAIDs may be recommended to decrease swelling and pain. NSAIDs are available without a doctor's order. Ask your healthcare provider which medicine is right for you and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly. If you take blood thinning medicine, always ask your healthcare provider if NSAIDs are safe for you.

  • Steroid injections may help decrease pain and swelling. Steroids are injected into the carpal tunnel.

  • Transcutaneous electric nerve stimulation uses mild electrical impulses to help decrease your wrist pain.

  • Surgery called decompression may be used to take pressure off of the median nerve in your wrist.

How can I manage my symptoms?

  • Apply ice to your wrist. Ice helps decrease swelling and pain in your wrist. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover the ice pack with a towel. Place it on your wrist for 15 to 20 minutes every hour, or as directed.

  • Rest your hands. Let your hands rest for a short time between repetitive motions, such as typing. If you feel pain, stop what you are doing and gently massage your wrist and hand.

  • Get physical and occupational therapy, if directed. Physical therapists will show you ways to exercise and strengthen your wrist. Occupational therapists will show you safe ways to use your wrist while you do your usual activities.

  • Use a wrist splint as directed. A splint will keep your wrist straight or in a slightly bent position. A wrist splint decreases pressure on the median nerve by letting your wrist rest. You may need to wear the splint for up to 8 weeks. You may need to wear it at night.

When should I seek immediate care?

  • You suddenly lose feeling in your hand or fingers and you cannot move them.

  • Your hand suddenly changes color.

When should I contact my healthcare provider?

  • Your symptoms get worse.

  • Your hand and fingers are so weak that you cannot grab, squeeze, or lift items.

  • You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.