Are you suffering from carpal tunnel syndrome?

• Do you have frequent burning, tingling or numbness in your hands and fingers?
• Have you been waking up at night with numbness and tingling in your hands?
• Are you losing sensation in your fingers and thumbs?
• Do you have pain radiating up your forearms?

If you have any of these symptoms—especially if you routinely perform repetitive hand motions such as typing, cutting hair or assembly line work—you could be suffering from carpal tunnel syndrome.

Step one: Get an accurate diagnosis

The numbness in your wrists and hands could be caused by carpal tunnel syndrome—but it could also be due to other conditions such as wrist arthritis or De Quervain's tenosynovitis. Carpal tunnel syndrome is often mis-diagnosed; that's why it's so important to be treated by a hand expert.

Dr. John Krebs specializes in hand surgery

Dr. John Krebs at the Center for Orthopedics is fellowship-trained in hand surgery, a sub-specialty of orthopedic surgery. He completed a Cleveland Combined Hand Fellowship at the University Hospitals of Cleveland and the Cleveland Clinic Foundation.

Dr. Krebs is board-certified in orthopedic surgery, and certified with added qualifications (CAQ) in hand surgery by the American Board of Orthopaedic Surgery. He is trained in state-of-the-art hand surgery procedures and can help restore your hands' normal function.

Dr. Krebs answers questions about
carpal tunnel syndrome

What is carpal tunnel syndrome?

“Carpal tunnel syndrome is a condition where the tendons in the wrist swell and put pressure on the median nerve that helps supply feeling in the hand. If you have carpal tunnel syndrome, your hand will have pain and numbness and might even wake you up at night. It often gets worse with certain activities, such as driving or performing repetitive motions.”

What is the carpal tunnel?

“The carpal tunnel is a space in your wrist surrounded by the carpal bones. The roof of the tunnel, the transverse carpal ligament, sits at the top of this tunnel. Over years of use, the ligament gets thicker and puts pressure on the median nerve. Nerves don't like pressure. Once you put pressure on that nerve, your fingers start going numb.”

What causes carpal tunnel syndrome?

“The cause of carpal tunnel syndrome is not completely understood—though we do know that women are three times more likely to develop this condition than men.

Some known causes of carpal tunnel syndrome are:

• Heredity
• Repetitive hand or wrist motion over long periods of time
• Hormonal changes due to pregnancy and menopause
• Diabetes
• Rheumatoid arthritis
• Thyroid gland imbalance”

How is carpal tunnel syndrome diagnosed?

“Carpal tunnel syndrome is normally diagnosed with a test called an electromyogram or EMG, which checks the health of the muscles and the nerves that control them. But even when an EMG indicates carpal tunnel syndrome, it doesn't necessarily mean you have it.”

Are patients with carpal tunnel syndrome often mis-diagnosed?

“Yes. Some patients who come in with chronic wrist pain have had an EMG and been diagnosed with carpal tunnel syndrome—but they don't have any numbness or tingling in their hands. In these cases, the patients do not have carpal tunnel syndrome; they have basal joint arthritis

“On the other hand, you could have a positive EMG test for carpal tunnel syndrome, but that doesn't necessarily mean you have any symptoms.”

How is carpal tunnel syndrome treated?

“If carpal tunnel syndrome starts to bother you, you can wear a carpal tunnel splint that keeps your wrist in a natural position and takes some of the pressure off the nerve. Over-the-counter anti-inflammatory NSAID medications such as ibuprofen can also help relieve the pain. Sometimes cortisone injections can also help.”

Is surgery ever needed for carpal tunnel syndrome?

“In some cases, yes. If your hands are numb all the time and carpal tunnel syndrome is bothering you at work and waking you up at night, carpal tunnel surgery can relieve the problem.”

How is carpal tunnel surgery performed?

“During this minimally invasive outpatient procedure, I transect, or cut across, the ligament that forms the roof of the carpal tunnel. This takes the pressure off the median nerve and relieves the pain and numbness of carpal tunnel syndrome. The incision is only 1/2", so there's minimal trauma to the nerve and faster recovery.”