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- Carpal Tunnel
“My wrist has been hurting for the past few months. I work at a desk job and use the computer daily. It is difficult for me to type due to the pain in my wrist. What should I do?”
Pain in the wrist can be caused by a number of different problems. Very often wrist pain, associated with repetitive use of the hands, such as computer or mouse use, can result from compression of a nerve in the wrist. The median nerve travels down the arm and crosses from the forearm into the hand under a ligament (the carpal ligament) and can become compressed in this area, this is called carpal tunnel syndrome. Carpal tunnel syndrome is very common and can occur in both men and women. Not only can the nerve compression cause pain in the wrist, it can also cause numbness and tingling in the fingers. The numbness usually affects the thumb, index and middle fingers predominantly. Many times patients will also have symptoms at night that wake them up and they have to shake out their hands to get the feeling back.
The initial treatment of carpal tunnel syndrome includes wearing a wrist splint at night while sleeping. This helps to maintain the wrist in a neutral position; often people will sleep with their wrists flexed, causing compression of the median nerve, which worsens symptoms at night and during the day. Non-steroidal anti-inflammatories can also be helpful initially. If the symptoms, pain and numbness, continue despite splints and anti-inflammatories, a steroid injection into the area
around the nerve can help to alleviate symptoms. If this combination does not resolve the pain and
numbness, surgical release of the carpal ligament is indicated to release the pressure on the nerve.
Often nerve conduction studies will be obtained to evaluate the nerve prior to surgical intervention
to assess the nerve at the wrist to ensure the level of compression. Carpal tunnel surgery is a
very successful procedure and patients often feel improvement in their pain immediately after the
surgery. Depending on how long the symptoms have been present, the associated numbness may
take longer to recover. Early diagnosis and treatment of carpal tunnel syndrome with splints and
anti-inflammatories can help to prevent more severe symptoms. Fortunately if the symptoms do
continue, we have a very good surgical treatment option.