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Numbness, pain in wrist could be carpal tunnel

By Megan Sprague | Lake Norman Navigator

Published: December 12, 2008

That tingling sensation in your wrist that just won't go away might be Carpal Tunnel Syndrome.

Dr. Scott Brandon of Piedmont Healthcare Orthopedics said the symptoms of carpal tunnel usually start at night with numbness or tingling in the hand.

"You might wake up and shake out your hand and try to make it come back to life, so to speak," he said. "It will gradually progress to the same feeling during the daytime and may affect your activities and manual dexterity."

Brandon described the pain as being mostly the thumb and first and second finger.

"Sometimes, my patients will also say that it shoots up their arm up to the elbow or possibly the shoulder," he said.

The carpal tunnel is a series of bones in the wrist with a ligament on top, Brandon explained. It forms a non-pliant tunnel that doesn't give, so when there is any swelling, it compresses the nerve, causing numbness and pain.

Brandon said it's time to see a doctor if symptoms start to affect daily life.

"When you start to lose your sense of touch or start to lose sleep, it's not going to get better by itself," he said. "When you're not sleeping, that makes everything seem worse."

For milder cases, Brandon recommended treatments with anti-inflammatories and splints for nighttime use.

"The wrist splints are effective because it doesn't allow the flexing or extension of your wrist, which compresses the nerve," he said. "A splint keeps you from tucking your hand under your chin or whatever you might do during the night."

The next step, he said, would be injections.

"Most patients respond very well to the injections for quite a while, but the symptoms will come back … they are a temporary thing," Brandon said. "If the splints and anti-inflammatories just aren't doing the job, surgery is the next step."

If surgery is warranted, it shouldn't be a major deal.

"It's an easy, outpatient procedure," he said. "It takes about 20 minutes. We'll check up on you in a week, then in another month, and after that, you should be totally done with us."

The surgery is done either open or endoscopically and has minimal complications.

"I wouldn't even call them complications; they're just what is expected," he said. "At first, your scar will be very tender and you will have a decreased grip strength, both of which will get better on their own within three months.

"Most people feel relief within days," Brandon said.

As far as not taking the symptoms seriously, Brandon strongly recommends paying attention to what your body is telling you.

"Carpal tunnel should not be left alone too long," he said. "If it progresses for a long time, the fatty tissue in your thumb may start to waste away, and that is irreparable."