Handy advice for carpal tunnel

Carpal tunnel syndrome is often thought to be caused by repetitive activities like typing or texting too much, but hand and upper limb surgeon Dr. Alejandro Badia says this impression is wrong.

The condition is actually the compression of a nerve in the hand, which can be aggravated by repetitive activities.

“Carpal tunnel syndrome is an extremely common as well as very misunderstood condition,” said Dr. Badia, who has treated many patients from the Cayman Islands in his Doral, Florida clinic.

He said carpal tunnel syndrome means that there is a compression of the hand’s median nerve, which sits inside a tunnel in the hand whose floor and walls consist of bones known as carpal bones. “The roof of this tunnel is a structure called the transverse carpal ligament,” he said.

“The symptoms most often reported with carpal tunnel syndrome are numbness and tingling in the hand, which often begins at night. Often there is also pain and weakness in the hand, particularly in the thumb.

“If allowed to progress for many years untreated, this could lead to atrophy of the muscles in the base of the thumb,” Dr. Badia said.

Besides the physical symptoms of carpal tunnel, the diagnosis is easily confirmed by a simple nerve conduction study, he said. “This measures the velocity and the latency of the nerve impulse across the median nerve at the wrist and can tell the physician if the patient has a compression of the median nerve,” the doctor said.

A recent breakthrough in treating the condition is endoscopic release, in which an incision of less than one centimetre is made in the crease of the wrist and an endoscopic – a tiny camera – is inserted. This allows the surgeon to see the inside of the hand and make the division of the ligament without a large, open incision.

“The key to understanding carpal tunnel syndrome is to think of this as a pinched nerve which occurs in the wrist and leads to symptoms such as numbness or tingling. These are many painful conditions in the hand and wrist which need to be evaluated by a surgeon specialising in such problems,” Dr. Badia said.

He said carpal tunnel syndrome is an easily diagnosable and treatable condition when evaluated by the appropriate type of physician. He advised people who suffer pain in their hands to take heart and not to quit their jobs if they require type, but to visit a specialist instead who can diagnose their problem.