Carpal Tunnel

Carpal Tunnel Syndrome is numbness in the hand.

This numbness of the fingers and hand, often with pain in the wrist, usually comes on after work, at night, or with gripping, and is often accompanied with stiffness and dropping things.

The cause of the numbness is swelling of the slippery membrane around the tendons in the tunnel where the tendons pass from the forearm into the hand. This swelling fills the tunnel and jams the median nerve against the top of the tunnel, causing nerve pain and numbness. It seems that over use or repetitive use can often cause this swelling.

Traditional treatment has been to open the top of the tunnel, thus taking the pressure off the nerve. While this surgery is usually successful, there is a certain amount of pain and weakness in the wrist for several months while healing progresses. The tightness can also return, as the top of the tunnel heals over and closes the tunnel again, with recurrence of numbness.

Another surgical treatment for carpal tunnel is to remove the bulk of the swollen membrane in the tunnel, thus reducing the contents of the tunnel and taking the pressure off the nerve. This surgery treats the cause of the problem as well as not weakening the wrist. Thus recovery is faster, easier, and return to work sooner. I prefer this second type of surgery, the reduction of the bulk in the carpal tunnel, not only because patients prefer it, but also because there are fewer postoperative problems, such as the chronic pain with gripping, and slow recovery when the top ligament is cut. But both surgeries work well, and can remove this debilitating pain, numbness and weakness.