Who Gets Carpal Tunnel Syndrome?

What does a violinist; butcher and dental hygienist have in common?  All work in occupations that predispose them to carpal tunnel syndrome.  Prolonged and repetitive hand motions, strong gripping and vibration have all been associated with an increased risk of carpal tunnel syndrome. Although carpal tunnel syndrome is not always associated with repetitive work or activities, it can cause significant functional limitation that can affect both work productivity as well as recreational activities. 

According to The National Institute of Neurological Disorders and Stroke, carpal tunnel syndrome is frequently the result of a combination of factors that increase pressure on the median nerve as it passes through the carpal tunnel passageway in the wrist.  When the tunnel becomes narrowed or when swelling around tissues surrounding tendons occurs, it can take up space in the carpal tunnel and crowd the nerve.  The pressure on the nerve can cause pain and other symptoms of carpal tunnel syndrome.  

Symptoms of Carpal Tunnel Syndrome:

• Numbness, tingling, burning and pain in the thumb and fingers
• Pain or tingling that travels up the forearm
• Weakness and clumsiness in the hand making it difficult to perform movements such as buttoning clothes

The Importance of Early Diagnosis

There are many reasons for people who suspect carpal tunnel syndrome to see a doctor sooner rather than later.  For one thing, symptoms tend to start out gradually and increase in severity over time.  If caught early there’s a greater chance that simple things, like wearing a splint, stretching the affected area (see below) or avoiding certain activities, will slow or stop its progression.  Additionally, the risk of permanent nerve damage is reduced with an early diagnosis.

Non-surgical and Surgical Treatments

Non-surgical treatments exist and may include:

• Splinting
• Non-steroidal anti-inflammatory drugs, like ibuprofen,
• Nerve gliding exercises
• Steroid injections

If non-surgical treatments fail to provide relief, “carpal tunnel release” surgery may be performed to increase the size of the tunnel and relieve pressure on the median nerveThe success rate of carpal tunnel surgery depends on many factors.  With respect to alleviation of symptoms, up to 90% success is reported.

Tedman L. Vance, MD is a board certified orthopaedic surgeon, fellowship trained in orthopaedic hand and upper extremity surgery.  He is hand certified by the American Board of Orthopaedic Surgery. 

Dr. Vance has consulted with thousands of patients with carpal tunnel syndrome.  He favors a conservative, non-operative approach, but, if appropriate, he has performed more than 1,000 carpal tunnel release surgeries:  http://www.perimeterortho.com/tedman-vance-md.html