Carpal tunnel syndrome can be treated conservatively or with surgical treatment options. Treatment for moderate or mild cases typically begins conservatively. However, if a patient presents with a severe case or symptoms persist despite conservative treatment methods, surgery is often recommended to avoid irreversible nerve damage from occurring.
Non-surgical
- Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs will help to decrease pain and inflammation in the carpal tunnel therefore reducing the pressure on the nerve.
- Wrist bracing or splinting: Splints are designed to help hold the wrist in a neutral position. The neutral position places the carpal tunnel at its widest diameter, taking the most compression off of the nerve. Nighttime splinting can prevent wrist bending while sleeping allowing reduced pressure on the nerve. Day splints may also be worn when performing activities that aggravate your symptoms.
- Cortisone Injections: Cortisone is a powerful anti-inflammatory agent that can effectively decrease the inflammation around the nerve itself, as the medication is supplied directly into the carpal tunnel. Typically, not more than 2 or 3 injections are given since repeated injections can create harm due to the side effects of the medication. It should be noted, that although cortisone injections have been proven effective in a large percentage of patients, the resulting relief can be temporary and the symptoms may recur.
- Activity changes: Adjusting your workstation or modifying your recreational activities to avoid long periods of wrist flexion or extension can help slow or stop progression of symptoms.
- Nerve gliding exercises: Specific exercises that help the median nerve move more freely within the carpal tunnel may be recommended by your doctor or therapist.
*If nonsurgical treatment does not relieve your symptoms or you have significant pain and numbness in the hand, your doctor may recommend surgery. In long-standing cases with constant numbness and wasting of your thumb muscles (atrophy), surgery may be recommended to prevent irreversible damage.
The surgical procedure performed for carpal tunnel syndrome is called a "carpal tunnel release." There are two different carpal tunnel release techniques: open and endoscopic.
Goal
- Relieve symptoms
- Reduce pressure on the nerve
Who qualifies?
- Patients who suffer from mild to moderate symptoms.
- Patients with severe cases may require surgical intervention.
Outcomes
- Non-surgical treatment methods can be helpful in reducing symptoms of carpal tunnel if the condition is diagnosed early on.
- If non-surgical methods fail to relieve symptoms, surgical intervention may be required.
