Carpal Tunnel Syndrome

Carpal Tunnel Syndrome refers to a type of compression neuropathy of the median nerve. Compression neuropathy occurs when the nerve is disturbed by continuous pressure . Inside the wrist lies a tight space bordered by bones on three sides and the carpal tunnel ligament holding everything in place like a watch-band. The contents of the carpal tunnel include the flexor tendons and the median nerve. The median nerve provides sensation to the thumb, index and middle finger and the motor function of the thumb. Compressing this nerve causes numbness, tingling and pain in the connected fingers, and eventually leads to weakness in the thumb. Carpal tunnel syndrome is the most common peripheral compression neuropathy, accounting for 90% of peripheral cases. Experts estimate that 5% of the US population suffers from carpal tunnel syndrome.


Every persons experience with carpal tunnel syndrome can vary slightly, but the most common symptoms include paresthesia (numbness/tingling), burning and pain in the thumb, index and middle fingers. Most often, the patients with carpal tunnel syndrome will find themselves accidently dropping objects and waking up in the middle of the night from hand/wrist pain. Severe cases of carpal tunnel will cause weakness of the thumb and difficulty getting the thumb out of the palm of the hand, such as when one tries to grasp around a cup.


Physicians can often diagnose carpal tunnel syndrome by confirming the symptoms and by performing a clinical examination including provocative physical examination tests to reproduce the symptoms. Patients may undergo US (ultrasound) studies in our office to examine the median nerve as it enters the carpal tunnel as well. At times Doctors require EMG (electromyography) and NCS (nerve conduction studies) to measure nerve conduction velocities to determine where and how the compression lies. Besides compressing the carpal tunnel, in rare cases it may compress the neck and the forearm as well. PM&R or neurology doctors can perform EMG/NCS, an invasive study that involves placing small needles the size of acupuncture needles in the forearm and hand and giving small electric shocks to determine nerve function and speed.

Our mission is to help patients to return to work, improve their quality of life, reduce dependence on medication and healthcare providers, and avoid persistent injuries.

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