Prevention
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What is the treatment for carpal tunnel syndrome?
It’s important to treat carpal tunnel
syndrome as early as possible after symptoms start. The choice of treatment for
carpal tunnel syndrome depends on the severity of the symptoms and any
underlying disease that might be causing the symptoms.
Initial treatment usually includes rest,
immobilization of the wrist in a splint, and occasionally ice application.
The various treatments for CTS are outlined
below.
Nonsurgical treatments
If the condition is diagnosed early,
nonsurgical methods may help improve carpal tunnel syndrome, including:
Wrist splinting.
A splint that holds your wrist still while
you sleep can help relieve night time symptoms of tingling and numbness. Night time
splinting may be a good option if you're pregnant.
Nonsteroidal anti-inflammatory drugs
(NSAIDs).
NSAIDs, such as ibuprofen (Advil, Motrin
IB, others), may help relieve pain from carpal tunnel syndrome in the short
term.
Corticosteroids.
Your doctor may inject your carpal tunnel
with a corticosteroid such as cortisone to relieve pain. Sometimes your doctor
uses an ultrasound to guide these injections.
Corticosteroids decrease inflammation and
swelling, which relieves pressure on the median nerve. Oral corticosteroids
aren't considered as effective as corticosteroid injections for treating carpal
tunnel syndrome.
If carpal tunnel syndrome is caused by
rheumatoid arthritis or another inflammatory arthritis, then treating the
arthritis may reduce symptoms of carpal tunnel syndrome. However, this is
unproved.
Surgical treatments
Surgery may be appropriate if your symptoms
are severe or don't respond to other treatments.
The goal of carpal tunnel surgery is to
relieve pressure by cutting the ligament pressing on the median nerve.
The surgery may be performed with two
different techniques:
Endoscopic surgery.
Your surgeon uses a telescope-like device
with a tiny camera attached to it (endoscope) to see inside your carpal tunnel.
Your surgeon cuts the ligament through one or two small incisions in your hand
or wrist. Endoscopic surgery may result in less pain than does open surgery in
the first few days or weeks after surgery.
Open surgery.
Your
surgeon makes an incision in the palm of your hand over the carpal tunnel and
cuts through the ligament to free the nerve.
Discuss the risks and benefits of each
technique with your surgeon before surgery.
During the healing process after the
surgery, the ligament tissues gradually grow back together while allowing more
room for the nerve. This internal healing process typically takes several
months, but the skin heals in a few weeks.
Alternative medicine
Integrate alternative therapies into your
treatment plan to help you cope with carpal tunnel syndrome. You may have to
experiment to find a treatment that works for you. Always check with your
doctor before trying any complementary or alternative treatment.
Yoga. Yoga postures designed for
strengthening, stretching and balancing the upper body and joints may help
reduce pain and improve grip strength.
Hand therapy. Early research suggests that
certain physical and occupational hand therapy techniques may reduce symptoms
of carpal tunnel syndrome.
Ultrasound therapy. High-intensity
ultrasound can be used to raise the temperature of a targeted area of body
tissue to reduce pain and promote healing. Research shows inconsistent results
with this therapy, but a course of ultrasound therapy over several weeks may
help reduce symptoms.
Complications
Complications of carpal tunnel syndrome are
uncommon but include atrophy and weakness of the muscles at the base of the
thumb in the palm of the hand. This can be a permanent complication if not
corrected early enough. This can lead to lack of dexterity of the affected
fingers.
Outlook
The outlook is generally excellent as
carpal tunnel syndrome usually responds to the conservative measures reviewed
above. Sometimes surgical operation is necessary, and residual weakness can
occur.
