The Carpal Tunnel

The carpal tunnel is a narrow passageway in the wrist that opens into the hand. It is surrounded by the bones of the wrist (underneath) and the transverse carpal ligament (across the top). The median nerve runs through the carpal tunnel and gives sensation to the thumb, forefinger, middle finger and half of the ring finger.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition in which there is pressure on the median nerve — the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.

Causes:

  • Alcohol abuse
  • Bone fractures and arthritis of the wrist
  • Cyst or tumor that grows in the wrist
  • Infections
  • Obesity
  • If your body keeps extra fluids during pregnancy or menopause
  • Rheumatoid arthritis

Symptoms:

  • Clumsiness of the hand when gripping objects
  • Numbness or tingling in the thumb and next two or three fingers of one or both hands
  • Numbness or tingling of the palm of the hand
  • Pain extending to the elbow
  • Pain in the wrist or hand in one or both hands
  • Problems with fine finger movements (coordination) in one or both hands
  • Wasting away of the muscle under the thumb (in advanced or long-term cases)
  • Weak grip or difficulty carrying bags (a common complaint)
  • Weakness in one or both hands

Treatments:

Carpal tunnel release is a surgical procedure that cuts into the ligament that is pressing on the nerve. Surgery is depends on how long the nerve compression has been occurring and its severity.

  • First the surgeon will make a small surgical cut in the palm of your hand near your wrist.
  • Then surgeon will cut the carpal transverse ligament to ease the pressure on the median nerve. Sometimes, tissue around the nerve is removed as well.
  • The surgeon will then close the skin and tissue underneath with sutures (stitches).

Sometimes surgeons do this procedure using a tiny camera that is attached to a monitor. The surgeon inserts the camera into your wrist through a very small surgical cut and looks at the monitor to see inside your wrist. This is called endoscopic surgery. The instrument used is called an endoscope.