Carpal tunnel syndrome: Manageable and treatable

Carpal tunnel syndrome: Manageable and treatable

Louis Catalano, III, MD, Hand Surgeon at the CV Starr Hand Surgery Center, Mount Sinai Roosevelt

With the amount of typing and swiping many New Yorkers engage in these days, it’s no surprise that lower arm aches and pains are on the rise. But many people with pain and tightness in their lower arms mistakenly assume that they are suffering from carpal tunnel syndrome — a condition that has been erroneously linked with typing or computer use. “A lot of people come to me, saying they have carpal tunnel syndrome, and they have no evidence of the condition at all,” says Dr. Louis W. Catalano, III, an orthopedic hand surgeon at Mount Sinai Roosevelt. “The link to computer use is a myth.”

Surprising causes of carpal tunnel

Carpal tunnel syndrome is caused by the compression of the median nerve at the wrist, at its junction with the palm. The most common symptom is numbness and tingling in the thumb, index, long and ring fingers (more rarely in the pinkie finger), which can radiate up and down the arm. It can also cause pain around the palms and forearm, Dr. Catalano says.

Causes of carpal tunnel syndrome include:

  • Repeated significant pressure on the base of the palm (for example, use of crutches or a jackhammer) that can compress the nerve, causing numbness and tingling, which can be constant or can come and go
  • Prolonged wrist flexion, or bending the wrist down toward the underside of the wrist. Some people sleep or work in positions of wrist flexion
  • Diabetes
  • Pregnancy
  • Hypothyroidism (not enough thyroid hormone)

Carpal tunnel syndrome diagnosis and treatment

Diagnosis includes a patient history and a physical exam that includes tests that check nerve function and the musculature (muscle arrangement) of the thumb. If those tests indicate carpal tunnel syndrome, a neurologist should also test the patient to confirm or deny the diagnosis.

“In the grand scheme of things, a carpal tunnel syndrome diagnosis shouldn’t be alarming, because it’s very treatable,” Dr. Catalano says. Treatment options include nighttime wrist bracing that prevents flexion during sleep and cortisone injections, which can be very effective for managing discomfort for patients with mild carpal tunnel syndrome. For patients who have moderate or severe disease, and have constant numbness and/or some muscle weakness, surgery is a next step.

Carpal tunnel release surgery is a very common procedure with minimal risk, Dr. Catalano says. “It’s important for the patient and the surgeon to be on the same page about expectations. It may take a while to fully heal after the procedure, but it can be a very effective solution,” he says.

To make an appointment with an orthopedic hand specialist, call 1-855-411-LWNY (5969) or visit the Mount Sinai Roosevelt Orthopedics and Sports Medicine website.

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