Nonsurgical Options for Treating Carpal Tunnel Syndrome

Nonsurgical Options for Treating Carpal Tunnel Syndrome This article discusses the symptoms and causes of Carpal Tunnel Syndrome (CTS) and nonsurgical treatment modalities for the condition.

If you feel numbness, pain and tingling sensations in one or both of your hands and these feelings become constant over time, it could be carpal tunnel syndrome (CTS). CTS is a painful condition that occurs when the median nerve (a narrow passageway on the palm side) in the wrist is compressed. The condition causes severe pain and tingling sensations in the affected hand and arm. These sensations develop gradually and become worse during the night. CTS mainly affect the thumb, and the index and middle fingers. As CTS gets worse over time, early diagnosis and treatment is crucial. If left untreated, the muscles at the base of the thumb may wither away, and the person may no longer be able to distinguish hot from cold with the thumb and finger. Leading multi-specialty pain management and rehabilitation centers in Brooklyn, offer effective treatment modalities that help relieve the nerve damage and other symptoms associated with the condition.

CTS can affect both men and women. Symptoms differ from person to person and can range from mild to severe. The initial symptoms include numbness or tingling in the thumb, index and middle fingers that comes and goes. Other related symptoms include thumb weakness, dryness of the skin in the fingers, and pain in the wrist, palm or forearm. As the intensity of the condition increases, it may become difficult to hold objects and perform manual tasks.

Causes and Risk factors CTS is the result of several other factors that put excessive pressure on the nerves and tendons in the carpal tunnel. The tendon that travels through the tunnel is wrapped by a sheath and lubricated by synovial fluid. This keeps the tendon sliding freely inside the sheath. In patients with CTS, the tendon or sheath tightens and creates swelling as extra synovial fluid is produced to cure the excess friction. In many cases, there is no single cause. A combination of risk factors can lead to the development of CTS. These include – •

Injuries – Wrist fracture, dislocation, sprains or crush injuries

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Medical and other conditions - Arthritis, diabetes, hypothyroidism, obesity and lupus, as well as use of birth control pills, pregnancy, menopause.

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Alterations in the balance of body fluids - Fluid retention may increase the pressure within your carpal tunnel, irritating the median nerve.

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Gender – CTS is more common in women.

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Genetics – It is estimated that 1 in 4 people with CTS have an increased risk of developing the condition if a family member suffers from the condition.

Treatment Modalities Diagnosis of CTS involves a detailed physical examination to test the feeling in your fingers and assess the strength of muscles in your hand. Physicians also review the pattern of symptoms. In some people, bending the wrist, tapping on the nerve or simply pressing on the nerve can trigger symptoms. Imaging tests such as X-ray, electromyogram and nerve conduction study will be conducted.

It is important to treat carpal tunnel syndrome soon after the after symptoms start. Pain management and rehabilitation services in Brooklyn involve a variety of nonsurgical treatment modalities to reduce pain and stiffness symptoms of CTS. These nonsurgical modalities include – Physical therapy – Physical therapy in Brooklyn involves a combination of therapeutic exercises that help improve joint function and mobility.

Non-steroidal anti-inflammatory drugs (NSAIDs) - NSAIDs may provide short-term pain relief.

Transcutaneous Electrical Nerve Stimulation (TENS) - In TENS, low-voltage electrical current is delivered through the skin via electrodes placed near the source of the pain to prevent the pain signals from reaching the brain.

Corticosteroids - Corticosteroids injections reduce inflammation and swelling, which relieves pressure on the median nerve.

Chiropractic care - Chiropractic treatment includes gentle manipulation of the wrist, elbow and cervical spine.

Ice or heat application – Applying heat and ice packs can provide short-term relief for pain and numbness. Ice packs reduce muscle spasm and swelling, whereas heat application relaxes the muscles.

If CTS symptoms do not respond to the above nonsurgical treatment modalities, surgery will be recommended. Surgery involves cutting through the carpel tunnel ligament to relieve pressure on the median nerve.

There are no definite strategies to prevent the occurrence of CTS, but you can reduce the stress on your hands and wrists by taking preventive steps such as: workstation changes, avoiding sleeping in positions that cause your wrists to bend or curl, taking short breaks from repetitive activities involving the use of your hands, keeping your hands warm, reducing repetitive/strong grasping activities, and rotating your wrists and stretching your palms and fingers.

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