Carpal Tunnel

The carpal tunnel is a narrow passageway on the palm side of your wrist, surrounded by bones and ligaments. The median nerve, which controls sensation and movement in the thumb and first three fingers, runs through this tunnel. When the tunnel becomes narrowed or tissues around it swell, the median nerve is compressed, leading to carpal tunnel syndrome.

Common Causes and Risk Factors
Carpal tunnel syndrome often develops gradually. Contributing factors include:

• Repetitive hand movements such as typing, assembly line work, using tools
• Prolonged wrist positioning like when you use a keyboard and mouse
• Pregnancy can cause fluid retention, which can increase pressure
• Medical conditions like diabetes, thyroid issues, or rheumatoid arthritis
• Genetics some people are simply born with a smaller carpal tunnel

Symptoms of Carpal Tunnel Syndrome
Symptoms typically begin gradually and may come and go at first:

• Numbness or tingling in the thumb, index, middle, and part of the ring finger
• Burning or aching pain in the wrist or hand
• Hand weakness, especially when gripping objects
• “Shaking out” your hands for relief, especially at night or in the morning
• Clumsiness or dropping items more frequently

Over time, symptoms can become constant and may lead to muscle wasting in the thumb if left untreated.

Diagnosing Carpal Tunnel Syndrome

Diagnosis starts with a physical exam and a discussion of your symptoms and daily habits. Your provider may perform specific tests, such as:

• Tinel’s sign tapping the nerve to trigger tingling
• Phalen’s test bending the wrist to check for symptoms
• Nerve conduction studies or electromyography (EMG) to confirm nerve compression

Treatment Options
Early diagnosis and treatment are key to avoiding permanent nerve damage.

Non-Surgical Treatment

• Wrist splinting, especially at night, to keep the wrist in a neutral position
• Activity modifications to reduce repetitive strain
• Anti-inflammatory medications (NSAIDs)
• Corticosteroid injections to reduce swelling and pressure
• Physical or occupational therapy to improve ergonomics and mobility

Surgical Treatment
If symptoms persist or worsen despite conservative care, carpal tunnel release surgery may be recommended. This outpatient procedure relieves pressure by cutting the ligament pressing on the median nerve.

Recovery and Outlook
Recovery from non-surgical treatment can happen in a matter of weeks with proper care. After surgery, most patients return to light activities within a few days and regain full hand function in a few weeks.

With early intervention, the outlook for carpal tunnel syndrome is excellent. Most patients experience significant symptom relief and can return to normal daily activities without limitations.

Why Choose Iowa Ortho?
At Iowa Ortho, our hand and wrist fellowship-trained orthopedic surgeons provide personalized care backed by years of experience. We’ll walk you through every step of the process and create a plan that works for your lifestyle and goals.