Carpal tunnel treatment
The goal of treating carpal tunnel syndrome is to reduce or exclude swelling and pressure on the median nerve as soon as possible. Fortunately, proper and timely treatment can usually relieve pain, numbness and tingling, and restore normal function of the wrist and hand. If carpal tunnel syndrome results from an inflammatory illness, such as rheumatoid arthritis, then treating the underlying condition generally also reduces the carpal tunnel syndrome symptoms. However, general treatment may include the use of splints or braces, anti-inflammatory medications, cortisone injections or surgery.
1. Nonsurgical therapy
Generally, nonsurgical treatments for carpal tunnel syndrome may be more effective for those experiencing only mild nerve impairment. If you try a non-surgical treatment and it does not work, do return to your doctor. In particular, if you have constant numbness in any part of your hand, or if you have any weakness of the muscles next to the thumb. These symptoms mean that the nerve is not working well and is at risk of permanent damage. However, most people with carpal tunnel syndrome experience effective treatment with nonsurgical methods, including:
Wrist splinting. A splint holds the wrist still during sleep to help relieve nighttime symptoms of tingling and numbness. Splinting and other conservative treatments are more likely to help people who experience only mild to moderate symptoms for less than 10 months.
Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs such as Ibuprofen may help relieve pain from carpal tunnel syndrome if an associated inflammatory condition is also present. You may be told to follow this routine with rest for a couple weeks and keep an eye on it to see what happens.
Corticosteroids. Your doctor may inject your carpal tunnel with a corticosteroid, such as cortisone, to decrease inflammation, which can help relieve pain as well as pressure on the median nerve. Oral corticosteroids aren't as effective as topical injections for treating carpal tunnel syndrome. Keep in mind that if the corticosteroid shot doesn't work a first time, you will probably be told that you should have another, and then another.
When the pain or numbness of carpal tunnel syndrome persists more than six months, surgery may be the best treatment option as it provides the best chance of long-term cure for CTS. Carpal tunnel surgery is quite a common operation. In fact, surgical treatment for carpal tunnel syndrome is the most frequent surgery of the hand and wrist, with nearly ½ million procedures annually performed in the US. However, the surgery is only performed if symptoms persist despite other treatments, or if symptoms are severe and the nerve is in danger of permanent damage.
During carpal tunnel surgery, a surgeon cuts the ligament pressing over the median nerve of the wrist. Surgery can be performed using an endoscope, a telescope-like device with a tiny camera attached to it that allows your doctor to see inside your carpal tunnel and perform the surgery through small incisions in your hand or wrist. In other cases, classical surgery involves making a larger incision in the palm of your hand over the carpal tunnel and releasing the nerve.
Surgery for carpal tunnel syndrome usually results in marked improvement, but you may experience some residual numbness, pain, stiffness or weakness. Soreness or weakness may take from several weeks to as long as a few months to resolve. If surgery appears to be the best alternative for relieving your symptoms or preventing further muscle degeneration, be sure to talk with your surgeon about the procedure that will work best for you and with your plans to return to your previous activity levels, both at work and at home.
In general, dealing with carpal tunnel syndrome requires some major lifestyle changes, and it can take time to work out a strategy. For short-term management of the condition, localized steroid injections can help (strictly a short-term remedy). Lifestyle changes can significantly help treat symptoms of CTS to lead a full life, as long as you are willing to take a few precautions. Alternative medicines may also help treat carpal tunnel syndrome, although they have not gained any significant recognition, nor have they been investigated properly at this time.
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