From a presentation by
Dr. David Lukowski
McLeod Orthopaedics Seacoast
People, who use their wrists a lot – such as typists and painters, can develop carpal tunnel syndrome, a pain in the wrist. McLeod Orthopaedic Specialist Dr. David Lukowski, MD, talks about the cause, symptoms and treatment.
Here are the major points of Dr. Lukowski’s presentation on Carpal Tunnel Syndrome:
In medical terms, “carpal” means wrist. If you look down the center of your wrist, it’s all in a tight package in a tunnel. If you get pressure on that nerve, first you’ll have numbness and then pain. In the beginning, a person typically experiences symptoms at night. For many sufferers, the pain and numbness wakes them up at night. Their fingers go numb. They have to shake their hand out. It progresses from there to affect driving, cellphone use and other activities. You don’t want to reach the point, where the numbness and the pain are constant. By then, you’re almost to the point of no return.
On a typical exam, X-rays aren’t needed, unless there’s some other thing I’m worried about in addition to the carpal tunnel issue. But typically, an orthopedic specialist can diagnose carpal tunnel with an exam and, then, a test called nerve conduction, which confirms the diagnosis. Neurologists at McLeod test the function of your nerves to determine the severity of the problem.
Basically, there are three treatment options. The first would be to wear splints at night to help prevent you from sleeping with your wrists in tight fists, which usually triggers numbness and pain. The second option is a cortisone shot, which we administer in the office. Many patients will see a benefit, even if it’s only temporary — at best lasting up to a year. If a patient no longer gets relief from the cortisone shot, we turn to surgery in the palm of the hand, where the tunnel is located. We cut that ligament and open the tunnel and relieving the compression, giving nerves in the tunnel room to move. That’s probably the most common surgery that I do.
This surgery is very successful with a near 95% success rate. The extent of recovery largely depends on how severe the problem was when we operated. The more severe the constriction and pain, the less chance you’re going to get complete resolution. However, people see resolution of their pain right away. It’s just the numbness that takes longer to resolve.
Find an Orthopedic Specialist near you.