Carpal Tunnel Syndrome: Treatment Options After 12 Years of Symptoms

Q: Carpal Tunnel Syndrome: Treatment Options After 12 Years of Symptoms

Hello： In response to your question, carpal tunnel syndrome, commonly known as "housewife's wrist," is caused by the thickening of the flexor retinaculum, which compresses the median nerve, leading to symptoms of hand numbness and weakness. <br>Diagnosis relies on clinical sympto

Wrist tunnel syndrome

Numbness in the fingers has been present for 12 years, starting during pregnancy.
The doctor mentioned that it could return to normal after giving birth.
How should it be treated?

linda kimg, 40~49 year old female. Ask Date: 2003/05/19

Dr. Shao Guoning reply Neurosurgery

Hello: In response to your question, carpal tunnel syndrome, commonly known as "housewife's wrist," is caused by the thickening of the flexor retinaculum, which compresses the median nerve, leading to symptoms of hand numbness and weakness.
Diagnosis relies on clinical symptoms and electromyography (EMG) tests to obtain an accurate diagnosis, while also differentiating it from cervical nerve compression, which may sometimes coexist.
In terms of treatment, initial management includes medication and rest for two weeks.
If symptoms are severe or nerve conduction studies indicate axonal degeneration, surgical decompression should be considered.
Currently, most procedures involve a minimally invasive carpal tunnel release, with an incision approximately 2 cm on the palmar side.
The surgery takes only about 20 minutes and does not require hospitalization; however, a special wrist brace should be worn for two months postoperatively.

Reply Date: 2003/05/19

More Info

Carpal Tunnel Syndrome (CTS) is a condition that arises when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. Symptoms typically include numbness, tingling, and weakness in the hand and arm. Given that you have been experiencing symptoms for 12 years, it is essential to explore both conservative and surgical treatment options.

Understanding Carpal Tunnel Syndrome
CTS is often associated with repetitive hand movements, but it can also be exacerbated by factors such as pregnancy, diabetes, thyroid disorders, and other health conditions. In your case, the onset of symptoms during pregnancy is not uncommon, as hormonal changes can lead to fluid retention, which may increase pressure within the carpal tunnel.

Treatment Options
1. Conservative Treatments:
- Wrist Splinting: Wearing a wrist splint, especially at night, can help keep the wrist in a neutral position, reducing pressure on the median nerve. This is often the first line of treatment.

- Activity Modification: Avoiding activities that exacerbate symptoms can be beneficial. Ergonomic adjustments to your workspace may also help.

- Physical Therapy: A physical therapist can provide exercises to strengthen the wrist and hand muscles, which may alleviate symptoms.

- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and relieve pain. Corticosteroid injections may also be considered for more severe cases.

2. Surgical Options:
- If conservative treatments do not provide relief, surgical intervention may be necessary. The most common procedure is carpal tunnel release, where the ligament pressing on the median nerve is cut to relieve pressure. This surgery can be performed through traditional open surgery or minimally invasive techniques.

- Given that you have had symptoms for an extended period, surgery may be more effective if there is no significant nerve damage. However, if there has been prolonged compression, some nerve damage may have occurred, which could affect recovery.

Post-Treatment Considerations
After surgery, most patients experience significant relief from symptoms, but recovery can vary. Physical therapy may be recommended post-surgery to regain strength and mobility in the wrist and hand. It is also essential to follow up with your healthcare provider to monitor your recovery and address any ongoing symptoms.

Conclusion
Given the duration of your symptoms, it is crucial to consult with a healthcare professional specializing in hand surgery or a neurologist. They can perform a thorough evaluation, including nerve conduction studies, to assess the extent of nerve involvement and recommend the most appropriate treatment plan tailored to your situation. Early intervention can prevent further complications and improve your quality of life.
In summary, while conservative treatments may provide some relief, surgical options may be necessary if symptoms persist. It is essential to have an open dialogue with your healthcare provider about your symptoms and treatment options to find the best solution for your condition.

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