I’ve been feeling some discomfort in my hand and wrist. Is there a common cause for this pain and what can I do about it?
Complaints of hand pain and numbness are very common. The hands receive much abuse through physical labor and daily activities. It is not uncommon to develop hand arthritis over time. It is also possible to develop a nerve condition called carpal tunnel syndrome. This occurs when the carpal tunnel of the wrist becomes overcrowded and pressure is applied to the major nerve in the hand called the median nerve.
The carpal tunnel is a space in the wrist that is enclosed by bone on three sides, with a ligament lying across the top to form the tunnel. Nine tendons and the median nerve pass through this tunnel. If anything causes this space to decrease in size or if the structures passing through it enlarge, the median nerve is compressed and results in discomfort of the hand and fingers. This condition is referred to as carpal tunnel syndrome.
Carpal tunnel syndrome can range from mild, intermittent tingling in the tips of the fingers to severe hand and finger numbness with a decrease in the mass of the muscle in the hand. If it’s caught early enough, before permanent damage occurs, this process can be reversed.
To diagnose carpal tunnel syndrome, a nerve conduction study or electromyogram (EMG) is performed. These studies measure electrical activity along the nerve and show whether the impulse is restricted at any point. If there is a restriction at the wrist, it is most likely a result of carpal tunnel syndrome.
Treatment of carpal tunnel syndrome depends on the severity and duration of the symptoms. Early on, a wrist brace at night may be all that is required to avoid the uncomfortable symptoms. This treatment works because many people have a tendency to sleep with a flexed wrist, which puts additional pressure on the median nerve. If the wrist is held in a neutral position, the pressure on the nerve is minimal. Altering activities and avoiding the things that seem to cause the discomfort may also be helpful. If the symptoms persist despite conservative treatment, surgical intervention may be necessary. If a nerve is allowed to be compressed for a long period of time, it can lead to permanent damage.
Carpal tunnel release is a simple surgery performed by an orthopedic surgeon. A small incision is made at the base of the palm, exposing the ligament that makes up the top of the carpal tunnel. This ligament is then surgically severed, uncovering the carpal tunnel. This will create space in the carpal tunnel, which takes pressure off of the median nerve. This will also allow nerve impulses to travel at a normal rate, thereby improving sensation and decreasing pain. Carpal tunnel surgery does not repair the nerve; it takes pressure off of the nerve to allow it to heal on its own. Some patients experience immediate and full relief of their symptoms. Others will see improvement over a 12-month period.
Carpal tunnel release is a proven method of treatment for relieving symptoms involving hand pain and numbness. If these types of symptoms are bothering you, talk to an orthopedic surgeon about treatment options that would benefit you.
Dave Stoll, PA-C
Orthopedic Care in the office of Jon Orjala, D.O.
Utica Park Clinic – Owasso
10512 N. 110th East Ave., Suite 220
Owasso, OK 74055
918.376.8959
