Carpal tunnel syndrome (CTS) — which causes pain, tingling or numbness in the palm, thumb, and first three fingers, or pain in in the wrist and forearm — has become more common in recent years, in part because of the hours upon hours many of us spend on keyboards, holding small electronic devices or working with vibrating tools. Physical conditions, such as diabetes, rheumatoid arthritis, pregnancy or wrist injury can also lead to CTS.

The syndrome is caused when there is swelling in a small structure in the wrist — the carpal tunnel — through which blood vessels and the median nerve pass from the arm to the fingers. The swelling compresses the nerve, causing tingling or pain. People often report that they have a weak grip, or that they have become clumsy, or that their hand feels “fat” or “swollen,” even though the hand appears perfectly normal. They often feel symptoms mostly during the night, although they may also notice them during daily activities, such as driving or reading a newspaper. In severe cases, damage to the nerve leads to long-term impairment and loss of muscle tone in the hand; this is visible as a lessening of the bulk of tissue at the base of the thumb.

Victoria Bruegel, MD, one of two fellowship-trained orthopedic surgeon who specialize in treating the upper extremities, particularly the hand and wrist, at Southcoast, says that CTS is the number one reason people seek hand surgery, and she sees roughly 10 patients a day in various stages of the ailment.

“The treatment we recommend depends greatly on the length of time that the person has been affected,” she says. “We rank each person’s condition as early or mild, moderate or severe — and develop a suitable plan from there.”

If conservative treatments, such as splinting or cortisone shots, don’t provide enough relief, Dr. Bruegel performs carpal tunnel release surgery. The 35-minute procedure involves severing a ligament in the wrist, which relieves pressure on the nerve.

“This surgery is very effective,” says Dr. Bruegel. Many patients who address the condition before it becomes severe report almost instant pain relief.

Dr. Bruegel has seen that most patients are very satisfied with the results of surgery. In cases where patients had severe CTS and nerve damage before surgery, they might not be able to regain their full sensation or grip strength, but, Dr. Bruegel points out, the surgery helps preserve function and halt the progression of nerve damage.

In addition, recovery from the surgery is usually quick. Patients return home with a soft dressing and instructions to avoid heavy lifting or gripping for two weeks, although light daily living activities, such as writing, driving and typing, are allowed. The majority of patients don’t even require physical therapy.

You don’t have to live with hand pain! Contact the orthopedics program at 844-744-5544 or go online to learn more about Carpal Tunnel Surgery.

carpal tunnel Health+ Fall 2017