There are many different treatments for carpal tunnel syndrome, but not all of them will work for everyone.
Not all cases of the condition will cause long-term problems in the hand, and some people may find it improves without any medical treatment. If there’s a particular cause for your problem, such as an underactive thyroid gland or arthritis, then your symptoms may improve by treating that.
Your doctor will talk to you about the different treatments available and help you decide which would be best for you. If the condition is severe and you’re experiencing weakness in your hand muscles, then it’s important to get treatment quickly, and you’ll normally be advised to have surgery.
Splints
A resting splint for your wrist will often help – particularly if your symptoms are worse at night. A working splint to support your wrist that pushes the palm back slightly may be helpful if certain activities bring your symptoms on.
An occupational therapist or physiotherapist will be able to tell you about the different types of splint. Some therapists may recommend exercises of the wrist that might help prevent the median nerve becoming stuck to nearby tendons.
Drugs
A steroid injection will be helpful in most cases, although the effect may wear off after weeks or months. A small amount of steroid is injected into the carpal tunnel, which helps to reduce any swelling.
A steroid injection into the wrist joint itself may help if you have arthritis in your wrist. The injection might feel uncomfortable at the time, but it can be very helpful in treating carpal tunnel syndrome.
If the steroid injection is helpful but your symptoms return later, your doctor might repeat the injection. But repeated injections can become less effective or cause skin changes so they might not always be given.
Surgery
You may need surgery if there’s severe compression of median nerve or if the numbness and pain don’t improve with other treatments. The surgery, known as carpal tunnel release or decompression surgery relieves pain by reducing the pressure on median nerve.
Surgery usually takes place as a day case. The operation is normally carried out under a local anaesthetic and may be done by conventional open surgery or by keyhole surgery. Your surgeon will be able to tell you which is most suitable for you.
Following the operation, you might need to wear a bandage on your hand and wrist for a few days. It’s important that you keep moving your fingers and arm to reduce stiffness and swelling, and to prevent the nerve and tendons getting caught up in the scar tissue that can form after the operation. You may be able to start gentle exercises on the same day as your operation.
Your stitches will usually be taken out between 10 and 14 days after the operation, though some surgeons use dissolving stitches instead which don’t need to be removed.
You should recover from the surgery in less than a month, although it may take longer to get all the feeling back in your hand, especially if you’ve had the condition for a long time.
Sometimes, the operation may not bring a complete recovery, especially if you have muscle wasting or loss of sensation in your hand but it should greatly reduce your pain. If you feel there has been no improvement in your symptoms in the first six weeks after your operation, you should speak to your surgeon.
During the first few weeks after surgery you should avoid heavy tasks, but you should start to use your hand for lighter activities, as long as it’s not too uncomfortable. You shouldn’t drive until you are able to comfortably make a fist with your hand.
For most people surgery is very successful. But as with all operations, there is a small risk of complications, which may include infection, nerve damage or scarring. On rare occasions, the pain may continue, or it may return some time after the operation, even if it had seemed successful at first.
Cervical radiculopathy is an umbrella term for radiating pain, numbness, tingling, or weakness caused by irritation of the cervical nerve roots.
What is Cervical Radiculopathy?
(Tingling in Arms)
Cervical radiculopathy describes pain or tingling in the arms, hands or fingers that is the result of a condition that irritates a nerve in the spinal column — in particular, in the neck (cervical). Cervical Radiculopathy is a disease of the root of a nerve in the cervical spine, possibly from a pinched nerve or a tumor, that becomes inflamed or damaged. This results in a change in neurological function such as numbness, altered reflexes, or weakness. Pain can radiate anywhere from the neck into the shoulder, arm, hand, or fingers.
Cervical Radiculopathy (Tingling in Arms)
This condition is an irritation or compression of one
or more nerve roots in the cervical spine. Because these nerves travel to the shoulders, arms and hands, an injury in the cervical spine can cause symptoms in these areas. Cervical radiculopathy may result from a variety of problems with the bones and tissues of the cervical spinal column.
What Are the Symptoms of Radiculopathy?
Commonly those who have a compressed nerve in the neck area experience pain, weakness, numbness, or tingling in the arms. The Pins-and-needles tingling and/or pain can range from achy to shock-like or burning and may also radiate from the arm to the hand.
What Causes Radiculopathy?
Typically, radiculopathy occurs when the tissues surrounding the nerve roots, like bones of the spinal vertebrae, change or shift in size. When this happens, they may narrow the spaces where the nerve roots are traveling inside the spine or exiting the spine. It can be caused by gradual degeneration of the spine or because of a spinal injury.
Cervical herniated discs (discs in your neck area) are also a common cause of radiculopathy. As a disc slips or shifts from place or becomes damaged and presses on nerves it causes the symptoms.
Other causes include bone spurs (areas of extra bone growth) due to inflammation from trauma, osteoarthritis, or other degenerative conditions such as cervical spinal stenosis. Some less common causes are spinal infections and cancerous or noncancerous growths in the spine that can press against the nerve roots.
If you’re feeling arm or hand numbness, weakness in the arms or hands, or radiating arm pain, the cause may actually be in your neck — without causing neck pain.
Treatment Options for
Cervical Radiculopathy
Non-Surgical Treatment Options for Cervical Radiculopathy
There are several ways to handle the numbness in your arm caused by a pinched nerve in the neck. Here are some of the most common recommendations:
- Rest or activity modification. Sometimes the tingling in the arm will go away after a period of rest that includes limited activities such as a sports, lifting heavy objects or sitting and standing in proper positions.
- Physical therapy. A physical therapist may be able to help you relieve tightened muscles that could be constricting the vertebrae and causing the pinched nerve.
- Ice and/or heat. Applying an ice pack or a heated gel pack to the neck might offer pain relief for some people. For example, using an ice pack after an activity that causes pain or numbness in the arm can help reduce inflammation and pain.
- Pain management with medication or injections. Over-the-counter (OTC) medications, such as aspirin, acetaminophen, or ibuprofen could likely be tried first. If they are not helping further investigation into the cause of the problem may be needed.
Surgical Treatment Options for Cervical Radiculopathy
If non-surgical treatment options aren’t helping, it may be time to see what can be done with minimally invasive surgery. It’s important that you return to a regular level of activity and a surgery may be able to provide the relief you need. The videos below give an overview of the various procedures that are available if your neck pain specialist feels it may be appropriate.
If you are in the North Houston, Conroe, The Woodlands, Spring area and believe you need to see a spine specialist for arm or hand numbness, weakness in the arms or hand or radiating arm pain, call our office at 281-880-0700 to schedule an appointment with Dr. Fayaz.