Carpal Tunnel Syndrome (CTS) is much more than just pins and needles. It’s sharp, radiating pain in your wrist, hand, and arm that wakes you at night. It’s tingling, numbness and weakness that doesn’t go away, even during the day. If you’ve been feeling this way for three months or more, you might have CTS and it’s time to see a doctor. If left untreated, CTS can cause the muscles at the base of the thumb to become permanently damaged, and a person can gradually lose total function of the affected hand.
What is Carpal Tunnel Syndrome?
CTS is a repetitive stress injury that can affect anyone. It usually occurs in adults, most often in those between the ages of 30 and 60. Women are three times more likely than men to develop CTS. The condition evolves through long-term repetitive, forceful and awkward movement of the hands, wrists and fingers. This puts stress and pressure on the median nerve and tendons in the carpal tunnel, which is located where the wrist meets the hand.
The median nerve runs from the forearm into the hand and controls feeling on the palm side of the hand and fingers. The median nerve also controls impulses that allow the fingers and thumbs to move. It does not, however, control feeling or function in the pinky fingers.
Who is at risk for Carpal Tunnel Syndrome?
There is no proven cause of CTS, but it usually occurs in people who use their hands for work or hobbies, such as assembly line work, meat and fish packing, and sewing, knitting and playing musical instruments. Studies have not proven that prolonged computer use causes the condition.
Injury, trauma, heredity and the size and shape of the wrist are key contributing factors in developing CTS. So are health conditions such as thyroid problems, diabetes, obesity, rheumatoid arthritis, pregnancy and menopause.
People with family members who have CTS are more prone to developing the condition, most likely due to similarities in their body structure. It is thought that women are affected more often than men because their wrists are smaller in size and circumference. When CTS develops during pregnancy, it usually goes away soon after delivery.
What are the signs of Carpal Tunnel Syndrome?
Symptoms of CTS develop gradually and most often first appear in one or both hands during the night since many people sleep with their wrists bent. Symptoms during the day indicate the condition is progressing. CTS starts out with frequent sensations of burning, tingling, itching and numbness in the palm of the hand and fingers, usually the thumb, index and middle fingers. The pain and discomfort can also extend into the forearm.
You may have Carpal Tunnel Syndrome if you are experiencing:
- Burning, tingling, itching and numbness in the hands and fingers, excluding the pinky fingers.
- Significant pain or numbness in the hands and arms during the night.
- Diminished strength and coordination in the hands and thumbs.
- Difficulty in forming a fist or the ability to grasp small objects.
- Inability to differentiate between hot and cold through touch.
How is Carpal Tunnel Syndrome treated?
When no relief is obtained from over-the-counter or prescription pain medications, or from resting the hands for a couple of weeks, or from splinting the wrists during the night, it may be time for surgery. Cooper’s surgeons are specially trained in treating the hands – and CTS in particular – through minimally invasive techniques.
“We relieve our patients’ pain and suffering through an outpatient procedure that takes less than 10 minutes and involves one very small incision,” said Cooper University Hospital surgeon Yuan Y. Liu, M.D. “Patients begin using their hands as much as they want in a day or two.”
Dr. Liu is one of the few surgeons in the region who specializes in performing endoscopic carpal tunnel release surgery using a single-portal technique where only one incision is made. He uses an endoscope, a medical device that combines a camera with a scalpel. During the procedure, Dr. Liu makes an incision less than a half-inch wide at the base of the wrist. Using the endoscope to view the transverse carpal ligament and median nerve, he snips the ligament, releasing the pressure on the nerve and thereby relieving the patient of the cause of the CTS symptoms. Dr. Liu does not cut into the palm nor does he disturb a large portion of the hand.
For CTS sufferers, Dr. Liu’s minimally invasive approach offers many patients a quicker recovery period and return to normal activities, as well as a decreased need for physical therapy and no external stitches, wrist wraps or splints.
Recovery, however, depends on how patients use their hands, and on which hand is treated. When the procedure is performed on the non-dominant hand of patients with low-risk jobs, those patients typically can resume normal activities within one or two days. When the surgery is performed on the dominant hand of patients with jobs that require repetitive hand movements, those patients may need four or more weeks to recover. In this case, physical therapy can help speed recovery.
Dr. Liu sees patients in Camden, Marlton and Washington Township.