Carpal Tunnel Syndrome Overview

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This common condition is caused by pressure on the nerve that runs through the wrist, causing pain and weakness in the hand and wrist.

Carpal tunnel syndrome is a painful, progressive condition that can cause tingling and numbness in your hand and wrist. It can also cause a sharp, piercing pain that shoots through your wrist and up your arm. Carpal tunnel syndrome is possibly the most common and treatable nerve disorder experienced today. It affects 4 to 10 million Americans, with middle-aged and older individuals, as well as females, more likely to develop the syndrome, according to the American College of Rheumatology.

The condition is caused by pressure on a nerve called the median nerve that runs from the forearm into the palm. The nerve runs through a small space in the wrist called the carpal tunnel.

The median nerve controls movement and feeling in the thumb and first three fingers (but not the little finger). Pressure on the median nerve can come from swelling, or anything that causes the carpal tunnel to become smaller. Some people are born with an increased risk because their carpal tunnels are smaller. This trait runs in families.

There are many risk factors for carpal tunnel syndrome, including:

  • Injury to the wrist that causes swelling. Bone dislocations and fractures can narrow the carpal tunnel and put pressure on the median nerve.
  • Assembly line work, such as manufacturing, sewing, cleaning, or meat, poultry or fish packing
  • Mechanical problems in the wrist joint
  • Repeated use of vibrating hand tools
  • Diabetes, which makes the nerves more susceptible to compression
  • Autoimmune diseases, such as rheumatoid arthritis and lupus. In an autoimmune disease, the body’s immune system abnormally attacks its own tissue. This causes widespread inflammation, which can affect the carpal tunnel.
  • Development of a cyst or tumor in the carpal tunnel

According to the Bureau of Labor Statistics, the 10 types of employment with the highest total number of carpal-tunnel-related events are:

  1. Cooks, institution and cafeteria
  2. Electrical power-line installers and repairers
  3. Painters, construction and maintenance
  4. Highway maintenance workers
  5. Welders, cutters, solderers, and brazers
  6. Bus and truck mechanics and diesel engine specialists
  7. Construction laborers
  8. Maids and housekeeping cleaners / Industrial machinery mechanics
  9. Laborers and freight, stock, and material movers, hand
  10. Automotive service technicians and mechanics

While many people associate carpal tunnel syndrome with computer use, the risk is much lower in computer users than in people whose work involves heavy labor.

In most cases of carpal tunnel syndrome, there is no single cause. Carpal tunnel syndrome is more likely in women than in men. This may be due to the smaller size of a woman’s carpal tunnel. Hormonal changes may also play a role. The condition usually develops in a person’s dominant hand.

In pregnant women, carpal tunnel syndrome may occur in both wrists. The syndrome usually goes away on its own after delivery, but symptoms can continue for 6 months or more.

In some people, carpal tunnel syndrome is a minor inconvenience, while in others, it becomes disabling. If a person’s carpal tunnel symptoms are mild and don’t last long, the condition often improves on its own. If a case is severe and untreated, the muscles at the base of the thumb may whither, and a person may permanently lose sensation.

Carpal tunnel treatment generally begins with a conservative approach, including rest, corticosteroid injections and splinting. Surgery may be recommended for people whose carpal tunnel syndrome does not improve with more conservative treatment.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Do I Need Carpal Tunnel Surgery

Do I Need Carpal Tunnel Surgery?

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Most of us use our hands almost every minute of the day without ever giving it a second thought. But if you have carpal tunnel syndrome, the pain, numbness, and tingling in your fingers get your attention. Treatments like wrist braces and corticosteroids can help, but in more severe cases, you may need surgery.

Carpal tunnel syndrome is caused by pressure on your median nerve. This is what gives you feeling in your thumb and all your fingers except your pinky. When the nerve goes through your wrist, it passes through the carpal tunnel — a narrow path that’s made of bone and ligament. If you get any swelling in your wrist, that tunnel gets squeezed and pinches your median nerve. That, in turn, causes your symptoms.

Whether you’ve decided to have surgery or are still thinking about it, you should know what to expect.

When Would My Doctor Suggest Surgery?

Over time, carpal tunnel syndrome can weaken the muscles of your hands and wrists. If symptoms go on for too long, your condition will keep getting worse. If any of these sound like your situation, your doctor might suggest surgery:

  • Other treatments — like braces, corticosteroids, and changes to your daily routine — haven’t helped.
  • You have pain, numbness, and tingling that don’t go away or get better in 6 months.
  • You find it harder to grip, grasp, or pinch objects like you once did.

What Are My Surgery Options?

There are two main types of carpal tunnel release surgery: open and endoscopic. In both cases, your doctor cuts the ligament around the carpal tunnel to take pressure off the median nerve and relieve your symptoms. After the surgery, the ligament comes back together, but with more room for the median nerve to pass through.

  • Open surgery involves a larger cut, or incision — up to 2 inches from your wrist to your palm.
  • In endoscopic surgery, your surgeon makes one opening in your wrist. He may also make one in your arm. These cuts are smaller, about a half-inch each. He then places a tiny camera in one of the openings to guide him as he cuts the ligament.

Because the openings are smaller with endoscopic surgery, you may heal faster and have less pain. Ask your doctor which operation is best for you.

Results and Risks

Most people who have carpal tunnel surgery find that their symptoms get cured and don’t come back. If you have a very severe case, surgery can still help, but you may still feel numbness, tingling, or pain from time to time.

Risks come with any operation. For both types of carpal tunnel release surgery, they include:

  • Bleeding
  • Damage to your median nerve or nearby nerves and blood vessels
  • Infection of your wound
  • A scar that hurts to touch

What’s the Surgery Like?

First, you’ll get local anesthesia — drugs to numb your hand and wrist. You may also get medicine to help keep you calm. (General anesthesia, which means you will not be awake during surgery, is not common for carpal tunnel syndrome).

When the operation is finished, your doctor stitches the openings shut and puts a large bandage on your wrist. This protects your wound and keeps you from using your wrist.

Your doctor and nurses will keep an eye on you for a little while before letting you go home. You’ll likely leave the hospital the same day. Overnight stays are rare.

How Long Does It Take to Heal?

You may get relief from symptoms the same day as your surgery, but complete healing takes longer. Expect to have pain, swelling, and stiffness after the operation. Your doctor will let you know what medicines might help. You may have some soreness for anywhere from a few weeks to a few months after surgery.

Your bandage will stay on for 1-2 weeks. Your doctor may give you exercises to do during this time to move your fingers and keep them from getting too stiff. You can use your hand lightly in the first 2 weeks, but it helps to avoid too much strain.

Slowly, you can get back to more normal activities, like:

  • Driving (a couple of days after surgery)
  • Writing (after a week, but expect 4-6 weeks before it feels easier.)
  • Pulling, gripping, and pinching (6-8 weeks out, but only lightly. Expect 10-12 weeks before your full strength returns, or up to a year in more severe cases.)

Your doctor will talk to you about when you can go back to work and whether you’ll be limited in what you can do.

Will I Need Occupational Therapy?

If you do, your doctor will suggest it once your bandage comes off. You’ll learn exercises to improve your hand and wrist movement, which can also speed up healing.

Some people find that their wrists aren’t as strong after surgery as they were before. If this happens to you, occupational therapy can help increase your strength.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.