What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common, and progressively incapacitating, condition affecting the thumb and first three fingers of one or both hands.

Its symptoms first appear as episodes of tingling or numbness with strenuous movement of the wrist, such as driving a car, knitting or typing.

If left untreated, the syndrome can progress until it is experienced as a constant numbness and generalized weakening of the hand which makes even simple tasks - buttoning a shirt, removing a lid from a jar - increasingly difficult. Carpal tunnel syndrome often wakens a sufferer during the night with a burning sensation in one or both hands.

Who gets Carpal Tunnel Syndrome?

Anyone whose job or hobby requires repeated wrist movement can be a victim of the syndrome. This commonly includes carpenters, mechanics, painters, artists, golfers, tennis players, knitters, dishwashers, and car drivers, among others.

Conditions associated with carpal tunnel syndrome can also contribute to its development. These include: pregnancy, rheumatiod arthritis, diabetes, vascular malformation, tendonitis, obesity, nerve tumors or cysts, and aging.

What causes Carpal Tunnel Syndrome?

The syndrome is a result of repetitive - though often minor - injury to the watchband-like carpal ligament which stretches across the wrist. The injury leads to scar tissue, making the ligament thicker. When this occurs, the carpal ligament takes up more room and presses down upon the Median Nerve beneath it. Nerve entrapment causes the tingling and numbness which can lead the eventual death of the nerve itself. Nerve death, in turn, creates atrophy of those muscles the nerve controls. (Hence, the function of the hand or hands weakens.)

When ignored over a period of months, the nerve injury can become permanent and irreversible; surgical intervention will prove futile.

How is Carpal Tunnel Syndrome diagnosed?

A diagnostic procedure known as an "Electromyography" is recommended when the syndrome is suspected. This test will show the degree of nerve damage and eliminate the possibility of other causes for symptoms experienced by patients.

How is the Syndrome treated?

The essential treatment known as "carpal tunnel release", involves surgically dividing the enlarged ligament to relieve pressure on the Median Nerve. The way we perform this procedure, which differs from that of many other surgeons, takes about fifteen minutes, under local anesthesia. (Both wrists may be operated on at the same time.)

A small, half-inch incision is made in the wrist; only two stitches are required to close it and, twenty-four hours later, a band-aid is the only evidence of surgery.

In the days following, there is usually a varying degree of discomfort, alleviated by Tylenol or propping the wrist on pillows, at night. The hand, or hands, may be used to the extent that this does not cause inordinate discomfort.

Results of Surgical Treatment

A study was conducted on 445 carpal tunnel patients, all of whom had undergone our technique of "carpal tunnel release" surgery on one or both hands. The total number of carpal tunnel release operations was 577, and the overwhelming majority (93%) produced good results.

Over half of the patients had full use of their hands in one week or less. No post operative physical therapy was necessary. Splinting was not required. And there were no injuries to the median nerve or any of its branches.

Two-thirds of the employed patients were back to work in three weeks and one-third of them had surgery on both hands at the same time.

The technique proved safe and very effective.

Neurology and Neurosurgery Associates, P.A., - 50 2nd St. S.E., Winter Haven, FL 33880