Hands - Procedures

During a physical examination, the doctor may identify numbness in the palm, thumb, index finger, middle finger, and thumb side of the ring finger. Hand grip may be weak.

Tapping over the median nerve at the wrist may cause pain to shoot from the wrist to the hand. This is called the Tinel's sign. Bending the wrist forward all the way for 60 seconds will usually result in numbness, tingling, or weakness. This is called the Phalen's test.

Electromyography and nerve conduction velocity will show decreased conduction across the wrist. Wrist x-rays should be done to rule other problems (such as wrist arthritis).

Treatment 

The first line of treatment often involves a splint to stabilize the wrist. The splint is worn at night for several weeks. If this does not help, you may need to wear the splint during the day. Hot and cold compresses may also be recommended.

There are many ergonomic devices that can be used in the workplace to reduce the stress placed on the wrist. These include special keyboards, cushioned mouse pads, and keyboard drawers. Make sure the keyboard is low enough so that the wrists aren't bent upward during typing. You may also need to make changes in your work duties or recreational activities. Some of the jobs associated with carpal tunnel syndrome include those that involve typing and vibrating tools. Carpal tunnel syndrome has also been linked to professional musicians.

Medications

Medications used in the treatment of carpal tunnel syndrome include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Corticosteroid injections, given into the carpal tunnel area, may provide relief of symptoms.

Surgery

Carpal tunnel release is a surgical procedure that cuts into the ligament that is pressing on the nerve. Surgery is successful most of the time, but depends on severity and duration of nerve compression.

After surgery, the damaged nerve must heal for the symptoms to improve. This can take months. In severe cases, the nerve may not be able to fully heal. Certain types of damage (such as muscular atrophy) may not be reversible.

In severe cases, electromyography or nerve conduction studies may be used to check how well the nerve is recovering.