On Your Health

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Do You Have Carpal Tunnel Syndrome?

03/19/2018

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Do you have persistent numbness and tingling in your hand and arm? You might have carpal tunnel syndrome, which is the most common compressive neuropathy in the upper extremity, otherwise known as a pinched nerve in your wrist.

The carpal tunnel is a narrow passageway located on the palm side of the wrist where the flexor tendons (they bend the fingers) and the median nerve pass from the forearm into the hand. This tunnel protects the median nerve and the flexor tendons. Carpal tunnel syndrome occurs when pressure builds up in this tunnel, compressing the nerve. 

Pressure on the nerve can be caused by swelling of the coating of the flexor tendons (tenosynovitis), joint dislocations, fractures, arthritis or fluid retention. Thyroid conditions, rheumatoid arthritis and diabetes can also be associated with carpal tunnel syndrome. In many instances, carpal tunnel syndrome is the result of typical everyday activities, such as the frequent use of vibrating hand tools or playing a musical instrument. There’s some debate over whether working at a computer can cause carpal tunnel syndrome.

Other symptoms of the syndrome include pain, a weak grip, occasional clumsiness and hand weakness.

Carpal tunnel syndrome is diagnosed with a detailed history and physical exam. Sometimes X-Rays are taken. Electrodiagnostic testing is sometimes used to confirm the diagnosis or check for other nerve problems.

Carpal tunnel syndrome may be relieved without surgery. Treatment options may include a wrist splint at night or during activities that aggravate the condition. A steroid injection into the carpal tunnel can also help.

When the symptoms are severe or don’t improve, hand surgery may be needed to relieve pressure on the nerve. This is done by cutting the ligament that forms the top of the carpal tunnel on the palm side of the hand. After surgery, tenderness around the scar can last several weeks or months.

The numbness and tingling in the hand or fingers may go away quickly or slowly — it may sometimes take up to a year. In severe cases where there has been permanent damage to the nerve, the symptoms may not completely go away after surgery.

The INTEGRIS Hand and Microsurgery Center is dedicated to providing excellent medical and surgical care for patients with hand, wrist and upper extremity diseases and injuries. Patients are provided a full spectrum of state-of-the-art care for acute injuries, post-traumatic reconstruction and chronic diseases.

The center provides care for patients of all ages from the newborn to the centenarian and everyone in between — including children with congenital musculoskeletal anomalies, adolescents with sports injuries, adults with cumulative trauma disorders and senior patients with geriatric upper extremity conditions.

The center also provides care for patients from all walks of life: weekend warriors with overuse conditions, athletes with sport injuries, workers with industrial and occupational diseases and retirees with arthritic disorders.

For more information, please visit the INTEGRIS Hand and Microsurgery Center website or call 405-945-4888.


About INTEGRIS hand surgeons:
Ghazi M. Rayan, M.D., is an orthopedic and hand surgeon. He is also a clinical professor of orthopedic surgery, adjunct professor of anatomy and the director of the Oklahoma Hand Fellowship Program at INTEGRIS Baptist Medical Center in Oklahoma City. Dr. Rayan is an honor graduate of the medical school at Alexandria University in Egypt. He completed a general surgery internship at the University of Maryland/South Baltimore General Hospital, an orthopedic surgery residency at Union Memorial/Johns Hopkins Hospital, and an upper extremity hand and microsurgery fellowship at the Raymond Curtis Hand Center in Baltimore. He is board certified in orthopedic surgery and hand surgery and has more than a quarter-century of experience. He is a member of 25 surgical societies, has given almost 250 presentations to domestic, national and international groups, published 175 scientific articles, wrote over 30 book chapters and edited seven books.

Margaret Porembski, M.D., received her medical degree from Georgetown University School of Medicine. She continued her clinical residency in general surgery at Loyola University Medical Center and Drexel University College of Medicine, and a hand surgery fellowship at INTEGRIS Baptist Medical Center. Dr. Porembski also completed a research fellowship in tissue engineering at the Center for Engineering in Medicine at the Massachusetts General Hospital in Boston.

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