Deciding what treatment is best for carpal tunnel syndrome (CTS) depends on a number of factors. Typically, your physician will start with the least invasive options. If those don’t bring relief, he/she will suggest more invasive treatments with the last option being carpal tunnel release surgery. How do you know what treatment is right for you? Answering two questions will help determine the best course of treatment for you.
How long have you had the CTS symptoms?
Conservative treatments have more success if treatment is sought early, some say within 10 months of symptoms starting. CTS is a progressive neuropathy which means that if a patient chooses to do nothing, the muscles in the hand which are “fed” input by the median nerve will waste away, and nerve damage may create a permanent disability. Treatment, therefore, is essential to ensure the functionality of the hand. These conservative treatments might start with wearing a wrist splint at night, perhaps icing the wrist, or even taking NSAIDs like ibuprofen or naproxen. Other conservative treatments include massage, exercises of the hand and fingers, and ultrasound treatment. These alternative treatments might be helpful; unfortunately, there is no consistent research proving their effectiveness in resolving CTS symptoms long-term.
How severe are your symptoms?
Analyzing your pain level and grip strength will help you understand the severity of your symptoms. Your physician will probably use a number of tests to determine the severity of your symptoms. For example, a physical exam will involve palpating the hand, wrist, and fingers to check for loss of feeling or an increase in numbness. An x-ray might be the next step to make sure there is no fracture or arthritis present. An electromyogram checks out electrical activity in the muscles and can also eliminate other potential conditions besides CTS. Lastly, a nerve conduction study looks at how well the median nerve is functioning. Tests like these will help you understand if you are in the early stages of CTS or if your symptoms have progressed.
Since conservative treatments are less successful when symptoms are more severe, your physician might suggest trying steroid injections or surgery. Steroid injections are fairly effective in providing short-term relief from symptoms, perhaps as long as 10 weeks; however, the symptoms will most likely return. When symptoms are severe, carpal tunnel release surgery is the best option for long-term relief. Surgery does provide relief from most symptoms, but patients must recognize that their hands will not be restored to the original state they were before CTS developed. The pressure exerted on the median nerve has likely created some damage, and if CTS was not treated early enough, the effects may not completely go away.
There are a number of treatment options for CTS, and most people are unsure where to start. Working with your physician, you can determine the duration and severity of your symptoms, and that will guide your decision. Doctorpedia encourages you to work closely with your physician to determine the best treatment for your CTS!
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- Carpal tunnel syndrome fact sheet. (2017). National Institute of Neurological Disorders and Stroke. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-Sheet
- Carpal tunnel syndrome: How effective are corticosteroid treatments? (2017). InformedHealth.org. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK279598/
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- Mayo Clinic Staff. (2017). Carpal tunnel syndrome. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/diagnosis-treatment/drc-20355608