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Carpal Tunnel Syndrome

Houston, Texas

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.

The carpal tunnel (the narrow, rigid passageway of ligament and bones at the base of the hand) houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed. The result may be pain, weakness, or numbness in the hand and wrist, radiating up the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed or traumatized.

Causes and Diagnosis

Any repetitive and forceful grasping with the hands, bending of the wrist, and arthritis may cause carpal tunnel syndrome (CTS). It can also be caused by numerous conditions or diseases such as pregnancy, diabetes, menopause, broken or dislocated wrist bones, and obesity.

Any repetitive motions that cause significant swelling or irritation of membranes around the tendons in the carpal tunnel can result in pressure and injury to the median nerve disrupting the flow of sensations from the hand up to the arm and to the central nervous system resulting in the sensation of numbness of the hands.

You should seek medical advice at the first signs of CTS. Dr. Leo Lapuerta will conduct a comprehensive evaluation of your situation and then will recommend a course of treatment best suited to your needs. Included in his examination will be an assessment of sensation, reflexes and hand strength. Nerve conduction studies and an electromyogram will show how the nerves and muscles work together by measuring electrical impulses along nerve roots and muscle tissue.

Treatments

There are many treatment options available for this painful and debilitating condition including non-surgical treatments such as physical therapy and rest. Sometimes patients are given a wrist splint to wear and will show considerable improvement with conservative treatments such as this.

Another treatment option is called mini-open carpal tunnel release and is used for patients who have been resistant to more conservative treatment. Another option Dr. Lapuerta may suggest is microsurgical carpal tunnel release surgery that uses a microscope to visualize and operate on the nerves involved with carpal tunnel syndrome. Microscopic mini-open carpal tunnel release can be particularly useful in severe and difficult cases of carpal tunnel syndrome. It is also beneficial in patients who continue to have carpal tunnel syndrome after initial carpal tunnel surgery and those who have developed a recurrence of carpal tunnel syndrome.

Endoscopic carpal tunnel surgery involves making two small incisions in the hand and forearm using a camera to assist in viewing the carpal tunnel to perform surgery. The possibility of nerve injury is slightly higher with this procedure; Dr. Lapuerta will explain all the risks of these treatment options with you at the time of your appointment.

To learn more about the diagnosis and treatment of CTS, please contact our plastic surgery office Pearland, Texas today to schedule your initial consultation.