Finger Tips: Carpal Tunnel Syndrome

Carpal Tunnel Syndrome: My hands fall asleep at night, do yours?

by Kevin W. Lanighan, M.D.

People in midlife or older may experience numbness in their fingers occasionally, or only at night. You may wonder, “Is this because I am getting older? Is it normal? Could I be sleeping on my hands funny? Maybe it’s because I type on a keyboard all day. Could it be from my neck? Someone told me it is probably from my neck.”

Carpal Tunnel Syndrome (CTS) is one of the most common and misunderstood conditions that affects people’s hands. And it is definitely not normal to wake up with numb hands or to have your hands “fall asleep” while driving or reading a book.

The carpal tunnel is a narrow passageway of ligament and bones of the wrist containing tendons and the median nerve. When swelling or inflammation occur in this narrowed area it can compress the median nerve and cause CTS. Symptoms can include tingling and numbness in the hand and sharp pain that radiates up the wrist and arm. Symptoms often increase at night, begin gradually, worsen abruptly, and typically worsen over time. Women are two to three times more likely to suffer from CTS than men because they are generally smaller, making their carpal tunnel smaller, and leaving less room for the nerve. Women can experience CTS with pregnancy, but it is most common in people who are in their 50s.

CTS is associated with chronic and inflammatory autoimmune conditions, such as diabetes, rheumatoid arthritis, thyroid disorders, obesity, and menopause. It can occur as a result of injury and repetitive work, especially if it involves awkward positioning and vibration, but is notassociated with typing. Fortunately, early diagnosis and treatment of CTS can help prevent nerve damage.

Conservative treatment options include rest, splints, and injections. Sometimes minimally invasive surgery is required to “un-pinch” the nerve. This is much easier than you think because it is accomplished in just minutes as an outpatient without general anesthesia. Minimally invasive endoscopic techniques are performed using a local anesthetic allowing for a quick recovery and return to normal activities. A small bandage is replaced by a band-aid the morning after the procedure, at which time you may shower and use your hand. Temporary tenderness and weakness improve over time, there are no stitches to remove, and therapy is not required.

It is very important to understand that carpal tunnel surgery does not fix CTS and cannot repair a damaged nerve. Every week I meet someone who “waited too long.” If you are experiencing symptoms of CTS or have been told that you need carpal tunnel surgery, talk with the hand team at Northtowns Orthopedics.

Kevin W. Lanighan, M.D. is a Johns Hopkins trained orthopedic surgeon who specializes in state-of-the-art, minimally invasive techniques, including endoscopic and arthroscopic surgery and the care of carpal tunnel syndrome, thumb pain, fractures and problems of the hand, wrist and arm. Learn more at www.northtownorthopedics.com or call 716-204-2550 to make an appointment.

 

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