Clinical Resource: Dr. Theresa Wyrick Explains Carpal Tunnel Syndrome: Symptoms, Testing & Treatment

Carpal tunnel syndrome is a condition I see  very frequently. It’s a nerve compression. Specifically, the media nerve as it passes through  the wrist runs through a very tight tunnel. And with use and age and time, carpal tunnel syndrome  can occur where there’s compression of the nerve. And so just like if you sit on your foot and your  foot goes to sleep and you have that numbness and tingling, this um compression that occurs at the  carpal tunnel causes similar nerve type symptoms. Numbness and tingling that occurs usually in  the fingers most commonly thumb, pointer finger, middle finger, and ring finger because that’s  the fingers that the nerve supplies. Often times people will notice it during specific activities.  Most commonly that would be like it wakes them up from sleep at night where their hand is numb  frequently or burning, tingling. They have to shake it out, reposition things. They’ll  also notice it when they’re holding a book or a magazine or a hymnal in church. If they’re  holding their phone up for a period of time, gripping a steering wheel, driving for a period of  time. Women sometimes will notice it when they’re putting on makeup or they’re blow drying their  hair. Anything that requires sort of sustained gripping, pinching for an extended period of  time is what tends to cause the symptoms to become more noticeable. Initial treatment for  carpal tunnel syndrome is usually non-surgical and that basically includes sleeping in a wrist  brace at night. And so many times if the symptoms are early or mild, just kind of starting, that’s  a good place to start. Often times we’ll send patient for what’s called a nerve conduction  test where it’s usually done by a neurologist or a physical medicine doctor. They place some  stickers on the arm. There are a few needle sticks that are involved as well, but it helps us really  figure out everything we need to know. It lets us know where is the sight of compression. Is it at  the neck? Is it at the elbow? Is it at the carpal tunnel? But then additionally, it tells us how  bad it is. So, it gives us a severity measure. And that really tells us, is this something that we  can continue to treat non-surgically with therapy, bracing, activity modifications, medications,  maybe steroid injections, or are we seeing really

severe signs of nerve compression leading to nerve  damage? And then we need to think more seriously about a surgery, and that would be the carpal  tunnel release surgery. Carpal tunnel syndrome is, I would say, one of the most minor and  also most successful surgeries that I do. It’s very frequent in my practice. It can be  done under straight local anesthetic in the

clinic setting for some patients if they’re  amenable to that or patients who maybe have a lot of other medical problems and aren’t really  a good candidate to undergo safe anesthesia. They may choose to do it as a straight local type  procedure in the clinic setting. Other patients, we do it in the operating room as an outpatient  surgery where we might just do a twilight sort

of anesthesia with some sedation and  some numbing medication. Either way, we’re typically able to avoid a general anesthesia  and still have the patient very comfortable. The procedure takes about 10 to 15 minutes to do. There’s just a small incision in the um upstream aspect of the palm just near the  wrist crease. The nerve runs through a tunnel in everyone. And so what we’re doing technically  is just opening the roof of the tunnel to take the pressure off the nerve and give the nerve  more room. And that’s often very successful at immediately getting rid of their nighttime  symptoms and getting them better rest at night

um and allowing that numbness and tingling  that occurs during the day to resolve as well.