Carpal Tunnel Syndrome

Carpal tunnel syndrome is a collection of signs and symptoms experienced by the patient. There are three stages of carpal tunnel syndrome – mild, moderate and severe. The way carpal tunnel syndrome is diagnosed is with a test called an EMG. This test involves the patient going to see a practitioner that will test the nerves and muscles – that will allow us to see how diseased or how damaged the nerve is in the palm. We’ll also perform a diagnostic musculoskeletal ultrasound in the office to see if you’re a candidate for the procedure.

The most common indications for carpal tunnel syndrome:

  1. Numbness and tingling in the fingers or the hand
  2. Shock-like sensations in the forearm, palm or the wrist
  3. Fingers falling asleep
  4. Losing dexterity in the fingers and potentially dropping things
  5. Waking up at night needing to shake the hand out
  6. Wrist pain

If the EMG shows us what how severe the symptoms are (either mild, moderate or severe) we can determine a treatment plan.

Typically, in the mild stage we employ non-surgical interventions, involving resting night splints, cortisone injections into the wrist, and physical therapy for strengthening the hand. Oftentimes we can get the symptoms of calm down with these non-invasive options.

Once you get to the moderate stage, we cannot determine when exactly you will progress to the severe stage of carpal tunnel syndrome, which is irreparable damage to the nerve in the wrist, due to this we typically recommend performing the procedure to cut the transverse carpal ligament in the carpal tunnel to make sure that you don’t get to the severe stage.

Once you have reached the severe stage of carpal tunnel syndrome, we cannot promise you that the symptoms are going to completely resolve with the procedure. We can ensure they will not progress further (get worse), but we cannot say that the hands will go back to being completely normal. This is why we oftentimes recommend that you have an ultrasound guided carpal tunnel release procedure done when you get to the moderate state.

Over the course of my practice I’ve seen a number of patients in different fields of work that have had carpal tunnel syndrome. We are not positive what causes carpal tunnel syndrome. We know that there is some correlation between people that use their hands often for work-related tasks. So oftentimes, I’ll see patients that are typists, carpenters, mechanics –individuals that are using their hands a lot – come in with these symptoms. Often these individuals benefit the greatest from the ultrasound guided carpal tunnel release procedure because they’re in a profession where they have to use their hands to do their work. This procedure provides the opportunity for the patient to get back to work significantly faster than a lot of other options for carpal tunnel release.

Learn more about Carpal Tunnel Syndrome treatments

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