Is hand pain waking you up at night? You may be compressing the median nerve during its path through the wrist referred to as the "carpal tunnel". Carpal tunnel syndrome, or median neuropathy at the wrist, can be an unpleasant, annoying experience, which may lead to nerve damage, poor hand function, and trouble performing daily tasks. Symptoms vary, but typically include pain, tingling or numbness in the hand and fingers (usually to the thumb, index and long fingers). You may notice symptoms are worse at night and cause you to shake or flick your wrist for relief, also referred to as the "flick sign". Progression may lead to daytime complaints which may extend behind the hand or wrist and up the forearm, and too much pressure on the nerve may cause permanent damage over time.
Potential risk factors include women, pregnancy, being overweight, thyroid issues, diabetes, congenitally narrow tunnel from development, repetitive motions or use of hands, exposure to constant vibration, and prolonged hand positioning. The dominant hand is more likely to be affected. Unfortunately, as society has become heavily reliant on technology, we find ourselves using hands a lot for prolonged times, such as using a computer mouse, texting, gaming, etc. These actions may increase pressure on the median nerve.
Physiatrists are thoroughly trained in diagnosing and prescribing treatment for carpal tunnel syndrome. After a thorough history and detailed neurological examination, we may continue with nerve conduction testing or ultrasound examination to confirm the diagnosis. This will allow us to rule out other potential sources of pain or numbness in the hand or wrist, such as De Quervain's tenosynovitis, trigger finger, tendinitis, and many others. The use of ultrasound is a growing real time tool to look at the median nerve and carpal tunnel structures. Other tests include nerve studies, referred to as electrodiagnostics, or imaging such as MRI. The good news is that many non-surgical and conservative treatments are available to prevent severe and potentially permanent nerve damage. Treatment options may include wrist splints, physical therapy, ergonomic adjustments, medications, and injections. Find out more by speaking with a provider at Spine West.
Written by Christopher Morelli, D.O.