Dear Doctor: Late at night I wake up with severe hand tingling, and I have to shake my hands out for several minutes for relief. My doctor told me I have carpal tunnel syndrome. What is that?
Carpal tunnel syndrome — what is it?
Carpal tunnel syndrome is a condition where a nerve affecting the fingers of your hand gets pinched and irritated. The nerve is called the median nerve. It runs in a tunnel-like canal in the middle of your wrist, from your forearm to your hand. Anything that causes pressure in that tunnel affects the median nerve and can result in numbness, tingling, weakness and pain in the hands.
Conditions that can lead to carpal tunnel syndrome include:
• Repetitive use of hands and wrists. Any job that produces constant movement of the wrists can do this. Typing is a prime suspect.
• Injury. Any damage to the wrist can put pressure on the nerve and cause symptoms.
• Diseases. Diseases like diabetes, where nerve damage is common, can also affect the median nerve. Other diseases like arthritis can also put pressure on the area that carries the median nerve and affect it.
• Fluid retention. Commonly seen in pregnancy, fluid can put extra pressure on the median nerve.
Carpal tunnel syndrome symptoms
• Tingling or numbness, especially in the fingers affected by the median nerve. This includes the thumb and all fingers except the little or “pinky” finger. You may notice the numbness or weakness while reading a book, driving a car, or even while sleeping. It can extend from your hand up your forearm.
• Weakness. You may notice that you drop items easily. This comes from weakness in your thumb and its ability to grab objects. The thumb is affected by the median nerve.
Treatment of carpal tunnel syndrome
Your doctor will take a good medical history of the problem and conduct a physical exam. Your doctor may also do imaging studies and studies to evaluate nerve and muscle function.
If one has mild symptoms, simply taking occasional breaks and avoiding activities that cause the wrists to flex may be helpful. Ice packs to decrease swelling may also be of benefit.
If these steps don’t help, your doctor may recommend:
• Wrist splinting. A splint that holds your wrist in place can relieve nighttime symptoms.
• Medications to reduce inflammation such as nonsteroidal anti-inflammatory drugs (NSAIDs). These medications can relieve inflammation and pain.
• Steroids. The injection of steroids directly into the area of inflammation can be very effective when other anti-inflammatory methods have failed.
• Surgery. There is a ligament that presses on the median nerve. This can be surgically cut, producing significant pressure relief. The ligament can grow back, but it often does so with more space, preventing the pressure and return of the condition. Surgery is usually the last resort, but can also work very well.
If you think you suffer from carpal tunnel syndrome, see your doctor. There are some excellent treatments that can have a positive impact on the quality of your life.
Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.
Charles E. Crutchfield III, MD is a board-certified dermatologist and clinical professor of dermatology at the University of Minnesota Medical School and a Benedict Distinguished Visiting Professor of biology at Carleton College. He also has a private practice, Crutchfield Dermatology in Eagan, MN.
He received his MD and Master’s Degree in molecular biology and
genomics from the Mayo Clinic. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine. Minnesota Medicine recognized Dr. Crutchfield as one of the 100 Most Influential Healthcare Leaders in Minnesota. Dr. Crutchfield specializes in
skin-of-color and has been selected by physicians and nurses as one of the leading dermatologists in Minnesota for the past 18 years.
He is the team dermatologist for the Minnesota Twins, Vikings, Timberwolves, Wild and Lynx. Dr. Crutchfield is an active member of both the American and National Medical Associations and president of the Minnesota Association of Black Physicians. He can be reached at CrutchfieldDermatology.com or by calling 651-209-3600.