Arizona Orthopedic Surgery Solutions for Carpal Tunnel
What is Carpal Tunnel
Carpal tunnel, also known as median nerve compression, is where the arm, wrist, and/or hand go numb and tingle due to a pinched nerve in the wrist. Factors causing carpal tunnel depend upon an individual’s wrist and arm structure, their health status and history, and the daily motions required by their job or profession. A general sense of weakness in the arm, wrist, or hand is normal too.
Carpal Tunnel Diagnosis
A doctor will ask about your medical history, if the arm, wrist, or hand has had previous injury or trauma, and to elaborate on your symptoms. A physical examination will require numerous tests to be conducted where the doctor is checking to see if numbness, tingling, sensitivity, weakness, and muscle atrophy are caused in the fingers, hand, and/or wrist. The Tinel sign test is where the doctor pushes or knocks on the median nerve, which is inside the wrist, to see if it affects the fingers. The doctor will also turn and grasp the wrist to see if the hand experiences any numbness or tingling. An instrument examines fingertip sensitivity by poking them while the eyes are shut. Muscle weakness and atrophy at the base of the thumb is looked for. Electrophysiological tests, such as nerve conduction studies and electromyogram (EMG), help doctors determine the extent of carpal tunnel and if nerve or muscle ruin has occurred. Likewise, x-rays, MRIs, and ultrasounds can be used to confirm and check for any other medical conditions.
Carpal Tunnel Treatment - Nonsurgical
Seeking treatment early on is vital to prevent symptoms for getting worse and, hopefully, from stopping them altogether. A wrist splint or brace can be used to immobilize the wrist during activities that require movements that compress or agitate the median nerve. When the pain hits, nonsteroidal anti-inflammatories can be taken. It may be necessary to change your activities or implement therapeutic stretches and exercises during the workday to prevent flare ups. For more severe flare ups, a doctor may use a Cortisone injection to alleviate the inflammation and pain. After a significant period of time and nonsurgical treatments no longer remedy the symptoms, your doctor may suggest surgery.
Carpal Tunnel Treatment - Surgical
There are two surgical procedures that have the same result. The idea is to enlarge the tunnel in which the median nerve lies to reduce the pressure exerted upon the nerve causing carpal tunnel. The surgery is known as “carpal tunnel release” with the two procedures being “open carpal tunnel release” and “endoscopic carpal tunnel release.” Open carpal tunnel release is where the doctor cuts open the hand and views the transverse carpal ligament, or the “top of the carpal tunnel,” themself. After seeing how the transverse carpal ligament is afflicting the median nerve, the doctor will cut the ligament to make more space for the median nerve and take away the pressure causing symptoms. The ligament tends to grow back in time, however. During endoscopic carpal tunnel release, the doctor makes smaller cuts, known as portals, and uses a tiny, high definition camera, known as an endoscope, to see the affliction in the wrist and hand. Like open carpal tunnel release, the transverse carpal ligament is cut to make more space for the median nerve, however with endoscopic carpal tunnel release, the doctor views the ailment inside the body with a camera opposed to cutting the hand open and viewing the situation with their own eyes. As the hand isn’t cut open in endoscopic carpal tunnel release, a small, special knife is used to sever the transverse carpal ligament.