WESTCHESTER COUNTY, N.Y. -- Most people believe wrist pain from carpal tunnel results from too much time spent at a computer keyboard.
Interestingly, studies looking at the connection between excessive computer use and carpal tunnel syndrome have not found enough evidence to support a link.
A number of factors have been associated with carpal tunnel syndrome – including anatomy (a smaller carpal tunnel), gender (it’s more common in women), nerve damaging conditions, inflammation and thyroid disorders – but none has been established as a direct cause of carpal tunnel syndrome.
The carpal tunnel is a narrow passageway located inside the palm side of the wrist that is surrounded by bones, tendons and a wide band called the transverse carpal ligament.
Carpal tunnel syndrome results when a thickening from irritated tendons or other inflammation narrows the tunnel and causes the median nerve to be compressed. Symptoms of carpal tunnel syndrome include:
- Pain or numbness in the hand, wrist or forearm
- Numbness or pain in the fingers that causes waking at night
- Loss of thumb function and hand dexterity
- Reduced strength and grip in the fingers, thumb and hand
Patients with carpal tunnel syndrome typically complain of numbness or pain at night. There are other conditions that cause symptoms similar to those of carpal tunnel syndrome, including injury to the muscles, ligaments, tendons or bones; nerve problems in the fingers, elbow or neck; and arthritis in the thumb joint or wrist.
To diagnose whether you have carpal tunnel syndrome, your doctor will:
- Review your symptoms, making note of when symptoms occur
- Conduct a physical examination, testing the feeling in your fingers and the muscle strength in your hand
If the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome. Surgery may be necessary if symptoms are severe or persist for more than six months.
In performing standard open surgery, the surgeon makes a two-inch incision in the palm of the hand above the carpal tunnel and cuts through the ligament. This enlarges the carpal tunnel and frees the nerve.
Following surgery, soreness or weakness may persist for several weeks to a few months. Patients generally return to work in two to six weeks, depending on their occupation.
During the minimally invasive procedure known as an Endoscopic Carpal Tunnel Release or ECTR, the surgeon makes a tiny incision (1/2 inch) in the wrist and inserts an endoscope (a telescopelike device with a tiny camera attached to it) to see inside the carpal tunnel. He then divides the ligament, relieving the pressure.
The procedure takes approximately 10-15 minutes and can be comfortably performed under local anesthesia with the patient fully awake or with light sedation from an anesthesiologist.
Phelps is one of the few Westchester facilities where ECTR is offered. Surgery brings permanent relief to almost all patients and office workers are usually back at work within two to four days.
Jeffrey Jacobson, MD, performs the full breadth of plastic surgery in addition to hand surgery. Dr. Jacobson has offices in Harrison and Katonah (914-421-0123)