Treatment for Carpal Tunnel Symptoms

Carpal Tunnel Symptoms Diagnosis

A doctor will make a clinical examination of the patient to diagnose carpal tunnel symptoms.

Phalen’s test is performed by fully flexing the wrists to their maximum position and holding for a short period of time (typically one minute) until symptoms present. Flexing the wrists to 90 degrees will reduce the size of the carpal canal causing compression of the nerve in patients with carpal tunnel symptoms. The patient may be diagnosed with carpal tunnel symptoms if numbness or tingling results. The quicker the symptoms present, the more advanced the carpal tunnel symptoms.

Tinel’s test is to detect nerve irritation by tapping over the wrist and palm to cause tingling or “pins and needles” sensation in the hand and fingers.

Durkan’s test is to apply firm pressure to the base of the palm over the median nerve and carpal tunnel for up to 30 seconds until symptoms present.

Electrophysiological testing determines carpal tunnel symptoms

Electrophysiological testing can determine the degree of carpal tunnel symptoms.

When the median nerve is compressed it will conduct more slowly or poorly compared to other nerves.

Electro-diagnostic testing measures the speed of conduction to determine whether the nerve is under stress or not.

A patient with true carpal tunnel symptoms will never suffer any sensory loss, numbness or tingling in the base of the palm and at the base of the thumb because the branch of the median nerve that innervates those areas of the palm branches off the median nerve before the carpal tunnel passing around the carpal canal not through it.

Patients whose only symptom is pain are unlikely to have carpal tunnel symptoms. Patients with intermittent numbness and tingling often are only mild cases of carpal tunnel symptoms and not serious enough to be considered candidates for surgery.

Misdiagnosis of carpal tunnel symptoms

Misdiagnosis is common with carpal tunnel as there are many other conditions that have similar symptoms. Before the median nerve passes through the carpal canal it passes through the thoracic outlet and the two heads of the pronator teres muscle within the forearm. Any inflammation, compression or hypertrophy of these structures may irritate the median nerve producing a very similar set of symptoms to carpal tunnel syndrome. There may also be pain in the arm and elbow.

Carpal Tunnel Symptoms Treatment

The patient with carpal tunnel symptoms has a number of treatment options available.

 1.    Immobilization

The first and most simplistic treatment is to immobilize the hand and wrist by wearing a wrist brace or splint. This keeps the wrist straight, preventing movement and helps to rest the wrist. A brace or splint is particularly useful at night to prevent undue wrist movement while sleeping.

If there is heat in the wrist area the application of an icepack may be of benefit.

 2.    Physiotherapy & Massage

There is much evidence to show that when carpal tunnel symptoms first present and in milder cases of carpal tunnel symptoms physiotherapy and wrist exercises can be effective to control and relieve the carpal tunnel symptoms.

When a pregnant woman has developed carpal tunnel symptoms, the only safe carpal tunnel treatment option is to use natural methods until after the baby is delivered.

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 3.    Chiropractic

Some patients have claimed that chiropractic manipulation of the wrist and hand has helped relieve carpal tunnel symptoms. Patients who work with computer keyboards may gain some benefit from adjusting their chair height to maintain straight wrists and a more comfortable position.

Introducing some wrist stretching exercises and more rest breaks into their daily routine may dramatically reduce the carpal tunnel symptoms that are apparently caused by repetitive overuse of the hands.

4.    Drug Therapy

Non-steroid anti-inflammatory drugs are often prescribed to reduce the inflammation and swelling in the wrists. These drugs may have unwanted side-effects including gastro-intestinal upset and abdominal pain.

5.    Cortisone Steroid Injections

Some doctors will recommend an injection of local anesthetic and a corticosteroid into the wrist to reduce the carpal tunnel symptoms of pain and swelling. The injection can be very effective to eliminate the pain. However, this is a short-term solution only. Usually the doctor will only ever give one injection as the treatment is quite aggressive and not recommended for an extended period of time. Corticosteroids should never be given to patients with diabetes.

 6.    Surgery

If all of the above treatment options yield no result then the final option is an operation to relief the pressure on the median nerve.

Surgery is only recommended when there is advanced carpal tunnel symptoms of constant numbness, tingling, muscle weakness and pain that cannot be relieved by other treatment options.

Untreated Carpal Tunnel Symptoms

There are cases of carpal tunnel symptoms resolving themselves over time without treatment. However, this tends to be the exception to the rule. Normally if carpal tunnel symptoms are left untreated they may progress into more severe symptoms.

As with all medical problems, it is strongly recommended to take action as soon as you become aware of the condition. If a medical condition is not properly diagnosed and treated as soon as possible the condition may develop into a more severe case and be much more difficult to effectively treat. If left untreated carpal tunnel symptoms can result in permanent muscle and nerve damage and loss of function to your hands.

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