Carpal Tunnel Treatment

Carpal tunnel syndrome is a condition in which the median nerve is compressed as it passes through an opening from the wrist to the hand called the carpal tunnel. The carpal tunnel is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist.

Most cases of carpal tunnel syndrome have no specific cause, although there are a few factors that may contribute to the condition:

• Frequent, repetitive, small movements with the hands (such as with using a keyboard)
• Frequent, repetitive, grasping movements with the hands (such as with sports and certain physical activities)
• Joint or bone disease (arthritis, osteoarthritis, or rheumatoid arthritis)
• Hormonal or metabolic changes (for example, menopause, pregnancy, or thyroid imbalance)
• Changes in blood-sugar levels (may be seen with type 2 diabetes)
• Other conditions or injuries of the wrist (for example, strain, sprain, dislocation, break, or swelling and inflammation)

What are Treatments for Carpal Tunnel Syndrome?

Specific treatment for carpal tunnel syndrome is based on:

• Age, overall health, and medical history
• Extent of the disease
• Tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Patient opinion or preference

Common carpal tunnel treatments include:

• Splinting of the hand (to help prevent wrist movement and decrease the compression of the nerves inside the tunnel)
• Oral or injected (into the carpal tunnel space) anti-inflammatory medications (to reduce the swelling)
• Changing position of a computer keyboard, or other ergonomic changes

In certain cases, surgery may be necessary to relieve compression on the nerves in the carpal tunnel.

At Brigham and Women’s Hospital, orthopaedic surgeons in the Hand and Upper Extremity Service and plastic surgeons in the Division of Plastic Surgery provide advanced surgical procedures for carpal tunnel treatment.

Our surgeons utilize these minimally invasive surgical techniques to enable a quick recovery for the treatment of carpal tunnel syndrome. Often, carpal tunnel release can now be performed in less than ten minutes under local anesthesia.

In general, the surgery for carpal tunnel syndrome is performed in an outpatient location under local or general anesthesia. The surgeon will make an incision in the wrist area. The tissue that is pressing on the nerves will then be cut, in order to decrease the pressure.

Surgical approaches include:

• Open Carpal Tunnel Release - This is a traditional procedure used to correct carpal tunnel syndrome by the decompression of the median nerve. An incision is made through the transverse carpal ligament to enlarge the carpal tunnel and relieve the compressive on the median nerve.
• Mini-open Carpal Tunnel Release – This technique also involves small incisions placed away from the mid-palm.
• Endoscopic Carpal Tunnel Release – This technique transects the transverse carpal ligament through small incisions, often placed outside the palm and away from the surface of the hand. This less invasive technique has been developed to lessen the possible complications of the open procedure.

After carpal tunnel surgery, the wrist may be immobilized in a large dressing and wrist brace to help stabilize the area. The splint is usually worn continuously for the first two weeks after the surgery, but then is used intermittently for the next month or so. There is a moderate degree of pain in the hand after the surgery, which is usually controlled with pain medications taken orally. The surgeon may also have you keep the affected hand elevated while sleeping at night.

The length of recovery varies for each individual. If the nerve has been compressed for a long period of time, recovery may take longer. Movement of the fingers and wrists are encouraged a few days following surgery to help prevent stiffness.

Carpal Tunnel Syndrome Treatment at Brigham and Women’s Hospital

Surgeons in the Department of Orthopaedic Surgery and the Division of Plastic Surgery at Brigham and Women’s Hospital provide unique, innovative and comprehensive diagnosis, treatment and management for carpal tunnel syndrome as well as the full spectrum of diseases of the hand.

BWH surgeons who specialize in carpal tunnel syndrome.

Patient- and Family-centered Care

BWH has long been committed to not only the care of our patients but also the many other needs that they and their families have. This philosophy of patient- and family-focused care - involves systems and services that emphasize healing in a comfortable, relaxed environment.

Quality of Patient Care

Brigham and Women’s Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our inpatient satisfaction survey, sent to patients’ to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the quality of patient care we provide and how we are measured compared with other hospitals.

Contact Us

If you believe you should have an evaluation and would like to schedule an appointment with one of our carpal tunnel syndrome experts, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form.