Carpal Tunnel Syndrome

Carpal tunnel syndrome is compression of the median nerve at the wrist.

The carpal tunnel is an anatomic “space” in the wrist bordered by the bones of the wrist and transverse carpal ligament.  Through the carpal tunnel, course several tendons as well as the median nerve.  Swelling and compression in this confined space leads to dysfunction of the median nerve, an important nerve involved with function and sensation of the hand.

Typical symptoms of carpal tunnel include numbness in the hand, pain, and clumsiness.  The numbness is typically in the distribution of the median nerve (palm side of hand involving thumb, index, middle and half of the ring finger), although this can be variable.  Pain is generally a later sign and can be an indicator of more severe disease.  The symptoms can be worse at night, with activity and when driving.

Treatment options include splinting and anti inflammatories for mild disease and surgery for more significant disease.  Surgery involves surgical release of the transverse carpal ligament.  This allows the pressure on the median nerve to be resolved.  If there is nerve damage from longstanding or severe disease this may not improve fully despite relief of additional pressure.  For this reason, early treatment is recommended.