Do you feel a pins-and-needles sensation in your thumb, index, middle or ring finger? It could be carpal tunnel syndrome (CTS). You’ve probably heard of it: Popularly linked to keyboard work, CTS affects up to 10 million Americans. Yet plenty of misconceptions exist.
“Many people believe that carpal tunnel surgery creates permanent numbness or that typical recovery takes an extremely long time, but neither is true,” says Bishoy Saad, DO, a hand, wrist and upper extremity surgeon at Jersey City Medical Center (JCMC) and Cooperman Barnabas Medical Center (CBMC), and a member of RWJBarnabas Health Medical Group.
To promote better understanding of CTS, Dr. Saad shares answers to some of his patients’ most frequently asked questions.
What is CTS?
While CTS affects hands and fingers, it’s actually a condition of the wrist. It occurs when the median nerve—which runs through a wrist structure called the carpal tunnel—becomes compressed, putting pressure on the nerve.
What are key symptoms?
In addition to numbness and tingling, symptoms may include pain or a burning sensation in the wrist, hand or forearm. Discomfort often gets worse at night, making sleep challenging. People with CTS may also have trouble gripping a coffee mug or buttoning clothes.
Are keyboard users most at risk?
Excessive keyboard or computer use can cause CTS, but so can any other type of repetitive hand motion, such as playing guitar or cutting hair. CTS is often seen in people who use their hands in work or hobbies, including assembly-line and construction workers, cashiers, gardeners and knitters. Pregnancy and chronic conditions such as diabetes, rheumatoid arthritis, thyroid disorders and obesity can contribute to CTS, too.
Is CTS genetic?
It can run in families. One cause is anatomical; it occurs more often in people with a smaller carpal tunnel. CTS is three times more likely to occur in women than men, especially women over 45, likely due in part to hormonal changes.
Is surgery the only treatment?
No. Many mild-to-moderate CTS cases can be treated nonsurgically. Options include over-the-counter pain medications and wearing a splint to keep a hand in a neutral position, especially at night.
Avoiding repetitive motions or improving the setup of your workspace can help. Hand therapy can improve the movement of the median nerve. Corticosteroid injections can reduce inflammation for temporary relief.
When should surgery be considered?
We recommend surgery when symptoms are severe and you fail to find significant relief with more conservative treatments.
What does surgery do?
Two types of surgery—open and endoscopic—reduce pressure on the median nerve by cutting a ligament atop the carpal tunnel.
An open approach involves a larger incision—about two inches— in the palm. An endoscopic approach involves a smaller incision of about half an inch. It’s performed using an instrument with a camera that allows doctors to visualize and cut the ligament.
The endoscopic procedure generally entails smaller scars, faster healing and less blood loss. Our team performs endoscopic CTS surgeries at RWJBarnabas Health outpatient surgery centers in Livingston and Jersey City.
How long does recovery take?
Most patients improve significantly and can return to light activities within just a few weeks, gradually resuming more strenuous activities over the following one to three months as grip strength improves. Full recovery might take several months to a year.
When should I see a doctor for CTS?
Seek care if you feel persistent or worsening numbness in your hand that’s interfering with daily activities or if hand and wrist pain is keeping you up at night. Early diagnosis and treatment can prevent nerve damage and ease discomfort.
Steps to Prevent CTS
- Take frequent short breaks to rest your hands and stretch your wrists.
- Maintain good posture and avoid slouching. If you work at a desk, position your keyboard and mouse to keep your wrists straight, and adjust your chair so your feet are flat on the floor and your forearms are level with the keyboard.
- Avoid repetitive gripping.
- Try wrist exercises. For wrist flexor stretches, extend your arm with palm up while gently bending your wrist back with your other hand. For wrist extensor stretches, extendt your arm with palm down while gently bending your wrist down. Exercises from a hand therapist can help improve tendon movement.
- Maintain a healthy weight, and control conditions such as diabetes and arthritis.
Learn more about orthopedic care at RWJBarnabas Health, or request an appointment.
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