The initial symptoms of carpal tunnel syndrome are hand numbness, tingling, and burning. Initially the symptoms occur intermittently and worse at night when the patient is sleeping. The tingling often wakes up the patient, and they have to shake their hands to get rid of it. As the disease progresses the frequency and the intensity of the tingling and burning increases, eventually the symptoms can become constant and severe. As the carpal tunnel syndrome gets worse, the patient can develop weakness and paralysis of the fingers and the hands.
Carpal tunnel syndrome is caused by compression of the Median nerve as it passes through a tunnel in the wrist called the carpal tunnel. The Median nerve supplies the first three fingers of the hand, the thumb, index finger, and the middle finger. The Median nerve has two types of nerves bundled inside it. It has sensory nerves that sense information in the skin, and there are motor nerves that are used to move the muscles.
When the sensory nerves are injured, it causes numbness, tingling, or burning. If the motor nerves are injured it causes weakness and paralysis of the muscles.
Carpal tunnel syndrome occurs when the carpal tunnel becomes tighter and compresses the Median nerve. The tightening of the tunnel is associated with repetitive bending and straightening of the wrist which could occur in people that use the computer frequently, excessive texting, use of the cash register, or any activity that involves repetitive motion at the wrist. It is also associated with certain conditions like hypothyroidism, rheumatoid arthritis, diabetes, and pregnancy.
The diagnosis of carpal tunnel syndrome is made using a nerve test called EMG/Nerve conduction study. Since there are multiple other causes of hand tingling, nerve testing is crucial to know if the Median nerve is injured at the wrist, which would confirm the diagnosis of carpal tunnel syndrome, or is there another cause. It also gives us crucial information about how severe the injury is, which determines the type of treatment.
Early diagnosis of carpal tunnel syndrome is important since delay in treatment could lead to severe nerve injury which could be difficult to correct. Dr. Shaoulian specializes in performing EMG Nerve Conduction studies.
Once the diagnosis of carpal tunnel syndrome is made we will determine the best possible treatment for the patient trying to prevent further nerve damage and trying to reverse the process. The different treatment options include bracing, injections, physical therapy, and surgical correction. The treatment of carpal tunnel syndrome that is chosen depends on the severity of nerve damage shown on the EMG/nerve conduction study, making this test very crucial. The earlier treatment is started, the better the chances of recovery and usually without surgical intervention. Patients with carpal tunnel syndrome could have full recovery with minimal intervention if they seek medical attention and treatment early.