From an interview with
Dr. Christopher Zust
McLeod Neurological Associates

Carpal tunnel syndrome (CTS) is the name for a group of problems that includes swelling, pain, tingling, and loss of strength in your wrist and hand. Women are three times more likely to have CTS than men. McLeod Neurologist Dr. Christopher Zust tells us about the causes and treatments for this common condition.

“Carpal tunnel syndrome is caused by a pinched or compressed median nerve in the wrist. The median nerve provides the feeling in the thumb and all fingers except the pinky. As the nerve goes to the hand through the wrist, it passes through the carpal tunnel, which is a narrow path made of bone and ligament. When there is swelling or irritation in the carpal tunnel, the median nerve can be squeezed or pinched, causing the symptoms of carpal tunnel syndrome.

Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. Many activities can cause carpal tunnel syndrome, especially those requiring prolonged or repetitive flexing of the wrist, such as working on an assembly line. These activities can create harmful pressure on the median nerve in the carpal tunnel.

Other things that may be contributing factors to carpal tunnel syndrome include:

• Frequent, repetitive small movements like keyboarding
• Frequent, repetitive grasping movements used in some sports
• Joint or bone disease like arthritis
• Hormonal or metabolic changes like menopause or pregnancy
• Family history
• Injuries of the wrist, such as a strain, sprain, or break

Patients suffering from carpal tunnel syndrome may experience symptoms such as painful burning, tingling, itching, numbness, or a “pins and needles” sensation in the hand and sometimes the forearm. Some patients will have weakness in the hand and trouble holding objects. Patients may also say their fingers feel swollen, even though little or no swelling is apparent. The dominant hand is usually affected first and produces the most severe symptoms, but many patients have carpal tunnel syndrome in both hands (bilateral carpal tunnel syndrome). In most cases, carpal tunnel syndrome gets worse over time without appropriate treatment.

Women are three times more likely than men to develop carpal tunnel syndrome. This may be because the carpal tunnel area is relatively smaller in women than men. Those with diabetes are also at higher risk.

Early diagnosis and treatment are important to prevent permanent damage. Carpal tunnel syndrome is classified as a nerve disorder, which makes a neurologist the perfect provider to help manage the condition. If a primary care provider suspects their patient may be suffering from carpal tunnel syndrome, especially if symptoms are worsening, then a referral to a neurologist for evaluation can be the next course of action.

The neurologist will also be able to provide effective treatments to relieve symptoms associated with the nerve compression. Treatments may include a cortisone injection, splinting the hand to ease the compression of the nerve and/or anti-inflammatory medication. Worksite ergonomic changes that could help ease symptoms should also be considered.

Some cases require surgery to relieve the pressure of the compressed nerve. Carpal tunnel release is one of the most common surgical procedures in the United States. It is usually performed under local anesthesia and does not require an overnight stay in the hospital. Recovery from surgery usually takes 3 – 4 months.”

To learn more, speak with a neurologist near you.