FAQ’s on Carpal Tunnel Syndrome Treatment in Las Vegas

Carpal tunnel syndrome (CTS) results from compression of the median nerve and wrist structures. The carpal tunnel is a small tunnel-like component of the wrist composed of ligaments and bones. Through this tunnel runs tendons and the median nerve, which supplies the fingers and hand.

What does the median nerve do?

The median nerve controls sensation to all fingers of the hand (except the small finger), as well as the thumb on the palm side. When this nerve is compressed, irritated, or traumatized, it affects function of the fingers and thumb.

Is carpal tunnel syndrome common?

According a 2010 National Health Interview Study, approximately 3% of the U.S. adult population has carpal tunnel syndrome. This is around 5 million working adults.

What causes carpal tunnel syndrome?

CTS develops as the result of a combination of problems and factors. These include:

  • Congenital predisposition – The carpal tunnel is smaller than normal.
  • Over-activity – This is the result of repetitive use and movement of the wrist.
  • Injury and trauma – Fractures, sprains, and strains can cause damage to the median nerve or carpal tunnel.
  • Medical conditions – Pituitary gland dysfunction, development of a cyst or tumor, or thyroid disease can cause CTS.

Who is at risk for carpal tunnel syndrome?

Certain people are more at risk for developing CTS than others. Risk factors include:

  • Advancing age – CTS usually affects working adults, particularly middle-aged persons.
  • Female gender – Women are three times more likely to develop carpal tunnel syndrome than men.
  • Metabolic and hormonal conditions – CTS is often seen in people with diabetes, thyroid disease, and women who are menopausal.

What symptoms are associated with carpal tunnel syndrome?

Tingling, itching, burning, and wrist pain are all symptoms of CTS. This usually occurs in the palm-side of the hand and fingers, especially the thumb, index finger, and middle finger. Patients with this condition report feeling like their fingers are swollen and clumsy, and report dropping things and decreased grip strength. People with advanced carpal tunnel syndrome often report trouble buttoning shirts, picking up small objects, and making a fist.

How does the pain doctor in Las Vegas diagnose CTS?

To diagnose carpal tunnel syndrome, the doctor will take a medical history, ask you questions about your symptoms, and conduct a physical examination. To assess for fractures and arthritis, standard x-rays are done. Laboratory tests are used to check for thyroid disorder, diabetes, and metabolic disorders. Electromyography is used to assess damage to the median nerve, and electro-conduction studies are used to measure nerve impulses.

How does the Las Vegas pain management doctor treat carpal tunnel syndrome?

Treatment of carpal tunnel syndrome depends on the extent of the damage to the median nerve, the severity of tunnel narrowing, and patient’s functional status. Treatment options include:

  • Physical therapy – For strengthening of support structures and stretching of tightened tendons and ligaments, a physical therapy program is implemented. The therapist will use adaptive devices as necessary to assist the patient with activities of daily living.

 

  • Bracing/splinting – A brace or splint is often prescribed to keep the wrist in a neutral position. This alleviates pain at night that results from curling of the wrist.

 

  • Medicine – The pain medicine of choice is nonsteroidal anti-inflammatory drugs (NSAIDs), such as ketoprofen and naproxen. Topical analgesics can be used to decrease pain, including menthol, camphor, and capsaicin. For severe pain, narcotic analgesics are prescribed.

 

  • Corticosteroid injections – The doctor may inject a corticosteroid into the carpal tunnel to offer long-term pain relief. Steroids decrease inflammation and swelling of the associated wrist structures. A recent clinical study found that corticosteroid injections for CTS offered a 77% success rate for pain reduction and improve function.

 

  • Carpal tunnel release surgery – This surgery is the most commonly performed procedures in the United States. In this procedure, the doctor cuts the carpal ligament and makes room for the median nerve and tendons that are in the carpal tunnel.

Resources

Luckhaupt SE, Dahlhamer JM, Ward BW (2010). Prevalence and work-relatedness of carpal tunnel syndrome in the working population, United States, 2010 National Health Interview Survey. Am J Ind Medicine, 56(6), 615-624.

Mintalucci DJ & Leinberry CF Jr. (2012).Open versus endoscopic carpal tunnel release. Orthop Clin North Am, 43(4):431-7.

Visser, L. H., Q. Ngo, et al. (2011). Long term effect of local corticosteroid injection for carpal tunnel syndrome: A relation with electrodiagnostic severity. Clinical Neurophysiology.