When Does Carpal Tunnel Become Serious?

With the use of computer keyboards and popular handheld devices, increasing numbers of patients are experiencing hand pain, wrist pain, or both.  This pain is often due to carpal tunnel syndrome or other disorders such as basilar joint arthritis.  Understanding how this syndrome develops helps patients recognize when it has become serious and when to seek treatment.

How Does Carpal Tunnel Syndrome Develop?

Up to 6 percent of the U.S. population suffers from this disorder, according to the San Francisco Chronicle.  In addition to repetitive hand use, other risk factors include genetics, positioning of the hand and the wrist, being pregnant, or suffering from a variety of health problems such as rheumatoid arthritis or diabetes.

This condition develops when the median nerve, one of the primary nerves in the hand, becomes compressed while traveling through the wrist.  Without early treatment to relieve the pressure, symptoms typically worsen gradually and can cause irreversible nerve damage.

The American Academy of Orthopaedic Surgeons (AAOS) cites these common symptoms affecting the hand and the arm:

  • Pain
  • Numbness
  • Tingling
  • Burning
  • Periodic radiating, shock-like sensations
  • Hand weakness and clumsiness
  • Dropping items

Symptoms usually affect the thumb and the adjacent three fingers but could also include sensations that travel up the forearm, approaching the shoulder.

Wrist Pain and Hand Pain Treatment Options

Recognizing symptoms of a compressed median nerve is often a key to getting an early diagnosis.  Prompt treatment is necessary to make sure that patients do not suffer nerve damage that physicians are unable to reverse.  A free hand screening can identify this and other conditions, such as basilar joint arthritis, that cause hand pain or wrist pain.

With an early diagnosis, non-surgical methods are often effective in relieving symptoms, AAOS notes.  They include the use of:

  • Splinting or bracing
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
  • Changes in activity of the affected wrist and hand
  • Lifestyle and work modifications to stop progression of the disorder
  • Nerve-gliding exercise regimens
  • Injections of corticosteroids

If these methods fail to relieve symptoms over time, the physician will probably recommend surgery.  In some cases, the condition has persisted so long that the patient experiences constant numbness along with wasted thumb muscles.  Surgery might be the only option to prevent permanent nerve damage.

Two techniques relieve pressure on the median nerve.  Release surgery is the traditional procedure.  The surgeon cuts a ligament to increase space for the nerve.  This is usually an outpatient procedure that might be performed under either general or local anesthesia.

The less-invasive option is use of the open release procedure.  After making a small incision in the palm, the surgeon views the inside of the wrist and the hand through it.  The physician then divides the transverse carpal ligament to make more room for the median nerve.