Carpal Tunnel Syndrome Treatment
Treatments for carpal tunnel syndrome should begin as early as possible, under a
doctor's direction. Underlying causes such as diabetes or arthritis should be treated
first. Initial treatment generally involves resting the affected hand and wrist for at
least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in
a splint to avoid further damage from twisting or bending. If there is inflammation,
applying cool packs can help reduce swelling.
Non-surgical treatments of Carpal Tunnel Syndrome
Drugs - In special circumstances, various drugs can ease the pain and swelling
associated with carpal tunnel syndrome. Nonsteroidal anti-inflammatory drugs, such as
aspirin, ibuprofen, and other nonprescription pain relievers, may ease symptoms that have
been present for a short time or have been caused by strenuous activity. Orally
administered diuretics ("water pills") can decrease swelling. Corticosteroids
such as prednisone or lidocaine, injected directly into the wrist or taken by mouth, can
relieve pressure on the median nerve and provide immediate, temporary relief to persons
with mild or intermittent symptoms. (Caution: persons with diabetes and those who may be
predisposed to diabetes should note that prolonged use of corticosteroids can make it
difficult to regulate insulin levels. Corticosterioids should not be taken without a
doctor's prescription.) Additionally, some studies show that vitamin B6
(pyridoxine) supplements may ease the symptoms of carpal tunnel syndrome.
Exercise - Stretching and strengthening exercises can be helpful in people
whose symptoms have abated. These exercises may be supervised by a physical therapist, who
is trained to use exercises to treat physical impairments, or an occupational therapist,
who is trained in evaluating people with physical impairments and helping them build
skills to improve their health and well-being.
Alternative therapies - Acupuncture and chiropractic care have benefited some
patients but their effectiveness remains unproved. An exception is yoga, which has been
shown to reduce pain and improve grip strength among patients with carpal tunnel syndrome.
Surgical treatments for
Carpal tunnel release is one of the most common surgical procedures in the United
States. Generally recommended if symptoms last for 6 months, surgery involves severing the
band of tissue around the wrist to reduce pressure on the median nerve. Surgery is done
under local anesthesia and does not require an overnight hospital stay. Many patients
require surgery on both hands. The following are types of carpal tunnel release surgery:
Open release surgery, the traditional procedure used to correct carpal tunnel
syndrome, consists of making an incision up to 2 inches in the wrist and then cutting the
carpal ligament to enlarge the carpal tunnel. The procedure is generally done under local
anesthesia on an outpatient basis, unless there are unusual medical considerations.
Endoscopic surgery may allow faster functional recovery and less postoperative
discomfort than traditional open release surgery. The surgeon makes two incisions (about
½" each) in the wrist and palm, inserts a camera attached to a tube, observes the
tissue on a screen, and cuts the carpal ligament (the tissue that holds joints together).
This two-portal endoscopic surgery, generally performed under local anesthesia, is
effective and minimizes scarring and scar tenderness, if any. One-portal endoscopic
surgery for carpal tunnel syndrome is also available.
Although symptoms may be relieved immediately after surgery, full recovery from carpal
tunnel surgery can take months. Some patients may have infection, nerve damage, stiffness,
and pain at the scar. Occasionally the wrist loses strength because the carpal ligament is
cut. Patients should undergo physical therapy after surgery to restore wrist strength.
Some patients may need to adjust job duties or even change jobs after recovery from
surgery.
Recurrence of carpal tunnel syndrome following treatment is rare. The majority of
patients recover completely
.Modified 3-10-04
Information compiled from the National Institutes of Health
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