Carpal tunnel syndrome involves the compression of the median nerve in the wrist portion leading to tingling and numbness on the hands specifically on the index and middle fingers and thumb. A sharp shooting pain in the wrist area may also be experienced, sending you running to your local Wesley Chapel chiropractor’s office.
Treating carpal tunnel syndrome involves a variety of managements in order to address specific issues on the affected arm, hand and wrist. Most often, treatments vary depending on the severity of the median nerve compression. The following are the widely accepted managements for carpal tunnel syndrome:
The first line of management for carpal tunnel syndrome is rest, immobilization and icing. For instance, if you have been working for some time and felt numbness and sudden pain in your hands, the first thing that you need to do is to rest your working hands to prevent further injury to the median nerve. Those who require repetitive flexion of the wrist should be stopped immediately to avoid further compression. You may also want to immobilize the affected wrist to prevent further flexion and injury. A rigid splint is usually used to allow the wrist to maintain a neutral position. Immobilization is usually a conservative measure for mild to moderate carpal tunnel syndrome. Splints and braces are generally recommended at night and during activities that may possibly employ flexion of the wrist. Other than these cases, braces may be removed to prevent permanent effects of immobility such as joint stiffness. Finally, occasionally place ice packs over the wrist and hand to relieve pain.
Medications are also important for the management of carpal tunnel syndrome to improve the symptoms. Common medications prescribed include:
- Vitamin B6- Pyridoxine is usually prescribed to relieve numbness and tingling sensations through its action in improving the integrity of the nerves.
- NSAIDs- Non-steroidal anti-inflammatory medications are also used to relieve pain and reduce inflammation.
- Corticosteroids- For more severe cases of carpal tunnel syndrome, corticosteroids may be given orally or through direct injection in the affected joint to reduce inflammation and pain. Corticosteroids are only used for short-term management as it will not create permanent relief from symptoms.
In some cases, conservative managements may provide relief; however, surgery still becomes the only solution that can provide permanent symptomatic relief especially in those with severe CTS.
Chronic compression of the median nerve may lead to permanent nerve damage. In this line, surgery may be suggested to some patients with severe CTS. Surgical management involves the decompression of the carpal tunnel (carpal tunnel release) through severing the band of tissue around the median nerve along the wrist. Carpal tunnel release may be done through open wrist surgery or through arthroscopy.
After surgery or when conservative measures have been effective, rehabilitation is started to prevent the reoccurrence of symptoms. Rehabilitation may involve range of motion exercises of the wrist joint to reverse the effects of Carpal Tunnel Syndrome such as muscle atrophy in the hands.
Outcomes of CTS are generally acceptable and reoccurrence after surgery is minimal. Most individuals who got treated with CTS only had minimal or no nerve damage at all.