While there are a number of causes for hand numbness including nerve damage from diabetes or a pinched nerve in the neck, one of the most common causes we see as orthopedic hand surgeons is carpal tunnel syndrome.
What is carpal tunnel syndrome?
Carpal tunnel syndrome is caused by compression of the nerve in your wrist (i.e. the median nerve) as it passes beneath a band of tissue known as the transverse carpal ligament. Inflammation in the tendons of your wrist from overuse of your hands with repetitive activities such as typing are the most common cause. Other causes include pregnancy or trauma to the wrist.
How does it present?
Carpal tunnel syndrome usually presents with tingling and/or decreased sensation of the thumb, index, and long finger. The numbness is usually worse at night or with activities that involve prolonged grasping.
How can we evaluate it?
We can diagnose it by patient history and physical exam. Electromyographic (EMG) and nerve conduction studies (NCS) are other useful tests to help confirm the diagnosis of carpal tunnel syndrome.
How do we treat it?
Carpal tunnel syndrome can be treated non-operatively or operatively. Initial treatment usually focuses on nighttime wrist splinting and oral anti-inflammatory medications to decrease swelling in the tendons. Corticosteroid injections (i.e. cortisone shots) can also be attempted.
When all non-operative measures fail, surgical treatment may be required. Surgery involves making an incision in the transverse carpal ligament discussed above, releasing the pressure on the median nerve. This procedure is known as a carpal tunnel release.
Author:
Nicholas Pappas III, MD is a board-certified orthopedic surgeon with a Certificate of Added Qualifications (CAQ) in hand surgery who specializes in various hand and upper extremity conditions. He is the newest member of the Orthopedic Center for Sports Medicine team and founder of NOLA Hand Surgery (nolahandsurgery.com).
For appointments call 504-217-5319.
