Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a condition caused by pressure on the median nerve within the wrist's carpal tunnel. Common symptoms include numbness, tingling, and pain in the hand and fingers, often worsening at night.

Contributing factors may include repetitive hand movements, wrist position, genetics, and certain health conditions like diabetes. Treatment ranges from wrist splinting and anti-inflammatory medications to corticosteroid injections and, in severe cases, surgical intervention to relieve the nerve pressure.

Symptoms of carpal tunnel syndrome include:

• Numbness, tingling, or burning sensations in the thumb, index, and middle fingers.
• Pain and discomfort in the wrist, which may extend to the arm.
• Weakness in the hand, making it difficult to grip objects or perform tasks.
• Nighttime worsening of symptoms, often causing waking and the need to "shake out" the hand.

These symptoms result from pressure on the median nerve within the carpal tunnel of the wrist.

Carpal tunnel syndrome can be caused by a variety of factors:

• Repetitive hand motions, such as typing or assembly line work.
• Wrist anatomy, where smaller carpal tunnels can increase risk.
• Health conditions that cause swelling or nerve damage, like diabetes, rheumatoid arthritis, or thyroid disorders.
• Fluid retention, often related to pregnancy or menopause, which can increase pressure in the carpal tunnel.
• Injuries to the wrist that cause swelling or changes in the space within the carpal tunnel.

What are the treatment options for carpal tunnel syndrome?

• Wrist Splinting: Wearing a splint at night to keep the wrist straight and relieve pressure on the median nerve.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation, or corticosteroid injections to decrease swelling.
• Lifestyle Changes: Modifying activities that exacerbate symptoms, and ergonomic adjustments at workstations.
• Physical Therapy: Exercises to strengthen the wrist and hand muscles.
• Surgery: Carpal tunnel release surgery to relieve pressure by cutting the ligament pressing on the median nerve.

Reasons for minimal anesthesia during finger surgery 

Minimally invasive surgery with local anesthesia is often chosen for finger surgeries due to several key benefits:

• Reduced Pain and Discomfort: Local anesthesia limits pain during and immediately after the procedure without the side effects of general anesthesia.
• Faster Recovery: Smaller incisions and localized anesthesia contribute to quicker healing and shorter hospital stays.
• Lower Risk of Complications: With smaller incisions and local anesthesia, the risks associated with surgery, such as infections and bleeding, are minimized.
• Increased Precision: Minimally invasive techniques can provide surgeons with better precision, especially in delicate areas like the fingers.
• Convenience: Patients usually remain awake and can avoid the grogginess and recovery often required after general anesthesia, allowing them to return home the same day.

What are the surgical procedures for treating carpal tunnel syndrome?

Carpal tunnel surgery, aimed at alleviating the pressure on the median nerve, involves either an open or endoscopic method. In open surgery, a small incision is made in the palm to cut the transverse carpal ligament.

The endoscopic technique uses a smaller incision and a camera to guide the procedure, cutting the ligament from the inside out. This surgery is typically quick, performed under local anesthesia, and allows for a rapid return to daily activities, with full recovery in a few weeks.