Carpal tunnel syndrome is a common nerve condition that results in 400,000 carpal tunnel release surgeries every year. Whether or not you end up needing surgery depends on factors such as when you get treatment, the severity of your symptoms, and the extent of your nerve damage.
The experienced team at Prolete Physical Therapy & Sports Medicine has helped many patients avoid carpal tunnel surgery with tailored treatment plans that ease their symptoms and promote nerve healing. Here’s what you should know about carpal tunnel syndrome treatment and when you might need surgery.
About carpal tunnel syndrome
Carpal tunnel syndrome occurs when you have a pinched median nerve. The median nerve runs down your arm and into your hand, where it triggers muscle contractions and provides sensation to your palm, thumb, second and third fingers, and part of the ring finger.
The nerve travels through the bones of your wrist using a small passageway called the carpal tunnel. Several tendons also use the carpal tunnel. Any time the tendons become inflamed or the surrounding bones are damaged, you end up with a pinched median nerve.
If you have carpal tunnel syndrome, you experience symptoms such as:
- Pain in your hand and wrist
- Tingling or numbness in your thumb, index, and middle fingers
- Feeling like your fingers are swollen (when they’re not)
- Limited finger movement
- Hand weakness
- Difficulty grasping small objects
- Dropping objects
- Inability to feel hot or cold
- Muscle wasting at the base of thumb (in advanced cases)
The symptoms are usually mild at first. As the nerve damage worsens, your symptoms get progressively worse.
Though you may only have carpal tunnel syndrome in your dominant hand, more than half of all patients have nerve compression in both hands.
Importance of early carpal tunnel treatment
Early treatment is the best way to avoid surgery. When you keep repeating movements that irritate the tendons and nerves, the problem gets worse and your chances of needing surgery increase. Without early treatment, you can also develop permanent nerve damage
Treatment for carpal tunnel syndrome
For all but the most advanced cases, the first line of treatment consists of nonsurgical and nonmedical therapies. Physical therapists specialize in the treatments recommended to relieve carpal tunnel symptoms and restore normal nerve function, such as:
- Nerve gliding exercises
- Wrist splinting (usually at night)
- Stretching exercises
- Therapeutic ultrasound
- Grip-strengthening exercises
- Teaching about neutral wrist position
- Recommendations for ergonomic changes
- Strategies for resting your wrist
Learning to perform activities without bending your wrist and wearing a splint at night to hold your wrist in a neutral position are two of the top ways to relieve nerve pressure and give the nerve time to heal.
When you need carpal tunnel surgery
You may need to consider surgery when:
- You have extensive nerve damage
- You have severe symptoms
- You have hand muscle atrophy (the muscles waste away)
- First-line treatments don’t improve your symptoms
- Steroid injections don’t improve your symptoms
- Your symptoms last six months or longer
Steroid injections represent the only routine medical treatment. When conservative treatments don’t work, getting steroids injected into the carpal tunnel may help you prevent surgery.
Though no one ever wants to have surgery, a carpal tunnel release may end up being the only way to relieve the pressure, prevent permanent nerve damage, and regain full, symptom-free function of your hand and fingers.
Carpal tunnel surgery involves cutting the ligament that forms the roof of the passageway. After surgery, you should have physical therapy to prevent scar tissue from forming, promote healing, and restore strength to your wrist. We also teach you exercises, ergonomics, and habits that help prevent future problems.