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Columbia Orthopedics Services

Diagnosis & Treatment

Carpal Tunnel Syndrome

Find a Carpal Tunnel Syndrome specialist

When carpal tunnel syndrome interferes with your daily activities and quality of life, it's important to seek medical attention. NewYork-Presbyterian's expert clinicians draw on state-of-the-art diagnostic methods and treatments to treat your discomfort and symptoms.

How is Carpal Tunnel Syndrome Diagnosed?

Diagnosis

If you’re having symptoms of carpal tunnel syndrome, your doctor will ask about any recent wrist, arm, or neck injuries. They will do a physical examination to evaluate the sensation and strength in your neck, shoulders, arms, wrists, and hands.

You may also be asked to undergo certain laboratory and imaging tests that can provide additional information. These include:

  • An ultrasound to provide images of the structures in the wrist and hand
  • Electromyography, which measures electrical activity in the muscles that are controlled by the median nerve
  • Nerve condition studies measure whether electrical impulses that are sent to the muscles are slowed by constriction in the carpal tunnel
  • X-rays to rule out any other injury to the wrist or hand that may be causing symptoms

Illustration showing areas affected by carpal tunnel syndrome

How is Carpal Tunnel Syndrome Treated?

Treatment

Timely treatment of carpal tunnel syndrome is key in avoiding long-term nerve damage. Some of the same measures used to prevent carpal tunnel syndrome can also help address symptoms. Additional treatment options include medications and therapy. In some cases, surgery is the best treatment option.

Nonsurgical carpal tunnel treatment options

Depending on the severity of your symptoms, your doctor may recommend one or more measures, including:

  • Avoiding activities that cause pain, numbness, and tingling in the hand
  • Taking more prolonged breaks between tasks that place pressure on the wrist and hand
  • Icing the wrist to reduce swelling
  • Use of a wrist brace at night to prevent pressure on the median nerve during sleep
  • Taking oral nonsteroidal anti-inflammatory drugs, such as ibuprofen
  • Steroid injections directly into the carpal tunnel to reduce inflammation

Surgical treatment for carpal tunnel syndrome

If nonsurgical treatments don’t relieve your symptoms after several weeks or months, your doctor may recommend carpal tunnel release surgery. One of two approaches may be used. In both cases, the goal is to create more space in the carpal tunnel, thereby relieving pressure on the median nerve and related symptoms.

  • Endoscopic or minimally invasive surgery - The surgeon makes small incisions and then uses an endoscope, a tool that guides small instruments to the surgical area, to release the transverse carpal ligament. A miniature camera allows the surgeon to view the area during surgery.
  • Open surgery - This requires a larger incision on the palm of the hand. As with endoscopic surgery, the transverse carpal ligament is cut or released to relieve pressure on the median nerve.

In some cases, additional tissue is removed to open the carpal tunnel. Following surgery, the two sides of the ligament that has been cut (or released) gradually grow back together. The carpal tunnel remains permanently enlarged. Patients can expect to experience some tenderness and weakness in the hand during the healing period. Your surgeon will provide guidelines to allow for a safe return to daily activities.

FAQs

FAQs

Jobs that require repetitive motion can put individuals at risk of carpal tunnel syndrome. Some examples include working at a keyboard in an office setting, cutting items for food preparation, and operating certain types of equipment (especially those that require high force or that vibrate). People who work in an assembly line in manufacturing jobs are also at increased risk.

If carpal tunnel syndrome is not treated, additional damage to the median nerve may occur, resulting in weakness in the fingers and thumb. Numbness in the fingers may also increase, leading to an inability to sense heat or cold and the associated risk of burns.

Because many people bend their wrists during sleep (a position that can put more pressure on the median nerve ), your doctor may recommend that you wear a wrist splint at night. This will ensure that the wrist remains in an alignment that protects the nerve.

Carpal tunnel syndrome symptoms typically worsen with repetitive movements, such as working at a keyboard, chopping food, or operating machinery. Activities that involve grasping, as required by certain sports or recreational activities, can also aggravate symptoms.

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Trust NewYork-Presbyterian for Carpal Tunnel Syndrome Treatment

If you are experiencing any of the signs and symptoms of carpal tunnel syndrome, NewYork-Presbyterian's team of orthopedic specialists can help. Our patient-centered approach ensures that every treatment option is explored to provide you with the best outcome possible. Call us today to make an appointment.