Krisha Hospital

Don't let carpal tunnel pain hold you back

Carpal Tunnel Syndrome

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    What is carpal tunnel syndrome?

    The carpal tunnel is a rigid passage in the wrist formed by bones and ligaments, housing the median nerve and several tendons. When this tunnel narrows or the surrounding tissues swell, it exerts pressure on the median nerve, leading to the symptoms of Carpal Tunnel Syndrome.

    This condition is more prevalent in individuals who engage in repetitive hand movements or have underlying health issues that increase susceptibility.

    Symptoms of carpal tunnel syndrome

    Carpal tunnel syndrome કાર્પલ ટનલ સિન્ડ્રોમ

    Carpal Tunnel Syndrome symptoms usually start gradually and worsen over time. Early recognition is crucial for effective treatment. Common symptoms include:

    1. Tingling or Numbness: Often felt in the thumb, index, middle, and ring fingers, especially during sleep or after repetitive activities.
    2. Weakness: Difficulty gripping objects or performing fine motor tasks, such as buttoning a shirt.
    3. Pain or Discomfort: Radiating pain from the wrist up the arm or down into the palm and fingers.
    4. Swelling sensation: A feeling of swelling in the fingers, even when no visible swelling is present.

    Causes of carpal tunnel syndrome

    Causes of carpal tunnel syndrome

    Several factors can contribute to the development of CTS, including:

    1. Repetitive motion

    • Activities involving repetitive hand and wrist movements, such as typing, sewing, or playing musical instruments, can strain the wrist over time.

    2. Medical conditions

    • Diabetes: Can cause nerve damage, including the median nerve.
    • Arthritis: Swelling in the wrist due to joint inflammation.
    • Hypothyroidism: A condition that may lead to fluid retention and swelling.

    3. Pregnancy

    • Hormonal changes during pregnancy often lead to fluid retention, increasing the risk of temporary CTS.

    4. Wrist injuries

    • Fractures, sprains, or other wrist traumas can alter the structure of the carpal tunnel.

    5. Genetics

    • A naturally smaller carpal tunnel or predisposition to tendon inflammation can run in families.

    Risk factors of carpal tunnel syndrome

    Risk factors of carpal tunnel syndrome

    Several factors can increase your likelihood of developing Carpal Tunnel Syndrome. These risk factors range from lifestyle habits to underlying medical conditions. Identifying and addressing these can help in preventing or mitigating the condition:

    1. Occupation-related risks

    • Repetitive hand & wrist movements: Jobs requiring continuous typing, assembly line work, or heavy tool use can strain the wrist.
    • Vibration exposure: Prolonged use of vibrating tools can increase stress on the median nerve.
    • Poor ergonomics: Improper workstation setups can lead to unnecessary strain on wrists.

    2. Age & Gender

    • Age: CTS is more common in individuals over the age of 30, with risk increasing as you age.
    • Gender: Women are more likely to develop CTS, possibly due to a smaller carpal tunnel structure and hormonal changes.

    3. Medical conditions

    • Diabetes: Increases the risk of nerve damage, including the median nerve.
    • Rheumatoid arthritis: Causes joint inflammation that can compress the median nerve.
    • Thyroid disorders: Hypothyroidism can lead to fluid retention and nerve compression.
    • Obesity: Excess weight places additional pressure on the wrist structures.

    4. Hormonal changes

    • Pregnancy: Fluid retention during pregnancy can cause temporary swelling in the carpal tunnel.
    • Menopause: Hormonal shifts may affect tendon and nerve health.

    5. Genetic factors

    • A naturally smaller carpal tunnel or a family history of tendon inflammation can increase susceptibility.

    6. Other contributing factors

    • Smoking: Impairs blood flow, potentially affecting nerve health.
    • Stress & Overuse: Excessive use of the hands and wrists without breaks can exacerbate inflammation and strain.

    How is carpal tunnel syndrome diagnosed?

    Accurate diagnosis of Carpal Tunnel Syndrome (CTS) is essential for effective treatment. A healthcare professional will typically use a combination of medical history, physical examinations, and diagnostic tests to confirm the condition. Below is a detailed look at the process:

    1. Medical history

    The first step in diagnosing CTS is obtaining a detailed medical history. The doctor may ask questions such as:

    • When did the symptoms begin?
    • Are symptoms worse at night or during specific activities?
    • Do you perform repetitive hand or wrist movements daily?
    • Are there any underlying health conditions, such as diabetes, arthritis, or thyroid disorders?
      This information helps identify potential causes or contributing factors.

    2. Physical examination

    The doctor will perform a physical examination of your hands, wrists, and arms. They may:

    • Inspect for weakness: Test the grip strength of your hand and fingers.
    • Check for tingling or numbness: Gently press or tap on the median nerve at the wrist (Tinel’s sign) to see if it triggers symptoms.
    • Perform the Phalen’s test: Ask you to flex your wrists by pressing the backs of your hands together for about a minute to check if it causes tingling or pain.
    • Look for muscle atrophy: In advanced cases, the doctor might observe wasting of the muscles at the base of the thumb.

    3. Nerve Conduction Studies (NCS)

    Nerve conduction studies are one of the most definitive diagnostic tools for CTS. This test measures how well electrical signals travel through the median nerve. A slowing of signals in the wrist area can confirm nerve compression.

    4. Electromyography (EMG)

    An EMG test may be conducted to evaluate the electrical activity of muscles and assess whether there’s any nerve damage. Thin needles are inserted into the muscles to record electrical signals during rest and contraction.

    5. Ultrasound

    Ultrasound imaging can help visualize the structure of the median nerve and surrounding tissues, identifying any swelling or abnormalities.

    6. Magnetic Resonance Imaging (MRI)

    An MRI may be used in rare cases to detect structural problems, such as a cyst or tumor, that could be compressing the nerve.

    Carpal Tunnel Syndrome (CTS) treatment in Ahmedabad

    Non-surgical treatments

    Non-surgical treatments of Carpal Tunnel Syndrome

    Non-surgical interventions are often the first step in managing Carpal Tunnel Syndrome, particularly if symptoms are mild or have just started. While these methods may provide temporary relief, they are not always effective for everyone, and symptoms can often return if the underlying issue isn’t addressed. Here are the non-surgical treatments we offer:

    • Wrist splints: Wearing a splint, especially at night, helps keep the wrist in a neutral position and relieves pressure on the median nerve.

      Cons: Splints can provide temporary relief, but they don’t address the underlying compression. Symptoms may persist or worsen over time without further intervention.

    • Physiotherapy: Specialized exercises and stretches can reduce tension in the wrist, improve mobility, and alleviate symptoms. Dr. Karn Maheshwari offers personalized physiotherapy regimens tailored to your condition.

      Cons: While physiotherapy can help manage symptoms, it may not fully eliminate the compression on the median nerve, especially in more severe cases.

    • Medications: Anti-inflammatory drugs or corticosteroid injections may be prescribed to reduce swelling and relieve pain.

      Cons: Medications offer short-term relief but do not resolve the root cause of the nerve compression. In some cases, frequent injections may even weaken surrounding tissues.

    • Activity modification: Adjusting your daily activities, such as taking frequent breaks from repetitive tasks or improving ergonomic setups, can reduce strain on the wrist.

      Cons: Modifications can ease discomfort but may not be practical for everyone, especially those in jobs requiring repetitive hand movements. Additionally, these changes won’t reverse the damage already done to the nerve.

    While these non-surgical options can help alleviate symptoms, carpal tunnel release surgery is often the most effective long-term solution, particularly for moderate to severe cases. Surgical intervention directly addresses the underlying cause of nerve compression, offering a higher likelihood of permanent relief and restoring full function to your hand.

    Surgical treatments

    Surgical treatments of Carpal Tunnel Syndrome

    If non-surgical treatments fail to alleviate symptoms or the condition is severe—such as persistent pain, numbness, or weakness that affects daily activities—surgery may be necessary. Surgery aims to relieve pressure on the median nerve by cutting the transverse carpal ligament, thereby creating more space in the carpal tunnel.

    Carpal tunnel release surgery

    Carpal tunnel release surgery is one of the most commonly performed procedures for this condition. It is highly effective in reducing symptoms and preventing long-term nerve damage.

    There are two main techniques for this surgery: Open surgery and Endoscopic surgery.

    1. Open carpal tunnel release surgery

    • Procedure:

      • The surgeon makes a small incision, typically about 2–3 cm, on the palm of the hand near the wrist.
      • Through this incision, the surgeon gains direct access to the transverse carpal ligament and carefully cuts it.
      • Cutting the ligament releases pressure on the median nerve, providing symptom relief.

    • Advantages:

      • Provides a clear and direct view of the surgical site, ensuring precision.
      • Suitable for patients with complex anatomical variations or severe cases.

    • Disadvantages:

      • Recovery may take longer compared to endoscopic surgery due to the larger incision.
      • Scarring and tenderness at the incision site may occur initially.

    2. Endoscopic carpal tunnel release surgery

    • Procedure:

      • The surgeon makes one or two small incisions, usually less than 1 cm, in the wrist or palm.
      • A tiny camera, called an endoscope, is inserted through one incision to provide a clear view of the ligament and surrounding structures.
      • Specialized instruments are inserted through the other incision to cut the transverse carpal ligament.
      • The use of an endoscope minimizes tissue disruption.

    • Advantages:

      • Minimally invasive, with smaller incisions and less tissue damage.
      • Reduced postoperative pain and faster recovery time.
      • Minimal scarring and improved cosmetic outcomes.

    • Disadvantages:

      • Slightly higher risk of complications if performed by an inexperienced surgeon.
      • May not be suitable for patients with severe or complex cases.

    Recovery after surgery

    Post-surgical recovery varies based on the individual and the severity of the condition. Here’s what to expect:

    Immediately after surgery

    • Pain management: Mild to moderate pain is common but can be managed with over-the-counter pain relievers or prescribed medications.
    • Immobilization:The hand may be bandaged or placed in a splint to protect the incision and promote healing.

    Short-term recovery (Days to Weeks)

    • Symptom relief: Many patients notice a significant reduction in symptoms like pain and numbness within days. However, complete relief may take longer if the nerve was severely compressed.
    • Activity restrictions: Avoid heavy lifting or repetitive hand movements during this period. Gradually resume light activities, such as writing or typing, as tolerated.

    Long-term recovery (Weeks to Months)

    • Physical therapy: A physical therapist may provide exercises to restore hand strength, flexibility, and range of motion. These exercises help prevent stiffness and improve overall function.
    • Scar management: Massaging the incision site with vitamin E oil or silicone gel can help minimize scarring.

    Full recovery

    • Open surgery: Recovery typically takes 4–6 weeks for mild cases and up to 3 months for severe cases.
    • Endoscopic surgery: Recovery is often faster, with many patients returning to light activities within 2–3 weeks.

    Long-term results

    • Most patients experience significant improvement in symptoms. However, in severe cases where nerve damage occurred before surgery, some residual weakness or numbness may persist.

    Prevention of carpal tunnel syndrome

    Prevention of Carpal Tunnel Syndrome

    Preventing Carpal Tunnel Syndrome (CTS) involves adopting strategies to reduce pressure on the median nerve and avoid repetitive wrist movements that contribute to the condition. Here are some key preventive measures:

    1. Ergonomics and Workspace Setup
    • Wrist positioning: Keep your wrists neutral and avoid bending them excessively during tasks like typing.
    • Desk setup: Adjust your chair and desk to maintain proper wrist alignment.
    • Frequent breaks: Take short breaks to stretch your wrists every 20 minutes.
    1. Hand & Wrist exercises: Regularly perform stretches and strengthening exercises for your wrists and hands to improve flexibility and reduce strain.

    2. Maintain healthy weight: Excess weight can increase the risk of CTS by adding pressure to the carpal tunnel. Aim for a healthy diet and regular physical activity.

    3. Avoid repetitive movements: Try to avoid prolonged repetitive wrist motions. Alternate tasks and use ergonomic tools to minimize strain.

    4. Manage health conditions: Conditions like diabetes and rheumatoid arthritis can increase the risk of CTS. Properly managing these conditions can help prevent nerve damage.

    5. Good posture: Maintain proper posture to ensure your wrist stays in a neutral position, avoiding unnecessary strain on the carpal tunnel.

    6. Use protective gear: For individuals engaging in activities that require repetitive hand movements, wearing wrist braces or splints can provide additional support.

    What makes us the best hospital for carpal tunnel treatment in Ahmedabad?

    We understand that dealing with Carpal Tunnel Syndrome can be frustrating and painful. Here’s why patients across Ahmedabad trust us for their care:

    Expertise of Dr. Karn Maheshwari

    He is a highly trained hand & wrist surgeon with years of experience in treating complex hand and wrist conditions like Carpal Tunnel Syndrome. His dual specialization ensures that you receive both surgical precision and comprehensive post-operative rehabilitation.

    Personalized treatment plans

    We believe that no two patients are the same. Dr. Maheshwari tailors each treatment plan based on your specific symptoms, lifestyle, and preferences, ensuring you get the most effective and least invasive care possible.

    Minimally invasive surgery

    When surgery is necessary, we use the latest techniques to reduce scarring, shorten recovery times, and get you back to your daily activities faster.

    Comprehensive physiotherapy

    Our in-house physiotherapy team, led by Dr. Maheshwari, provides targeted rehabilitation exercises post-surgery to ensure optimal recovery and restore hand function as quickly as possible.

    State-of-the-art facility

    Our hospital is equipped with modern medical technologies, ensuring precise diagnostics and advanced treatment options for every patient.

    Patient-centric care

    From your first consultation to your follow-up care, our team is dedicated to providing a comfortable, compassionate experience. We prioritize open communication, answering all your questions and keeping you informed every step of the way.

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    FAQs about carpal tunnel syndrome

    We provide a comprehensive range of services for CTS, including diagnosis, non-surgical treatment options (such as splinting and physical therapy), and surgical intervention when necessary. Our team specializes in managing CTS to help restore hand function and alleviate pain.

    To schedule an appointment, you can call our hospital or book an appointment online. Our staff will assist you with the scheduling process and provide you with any necessary information.

    During your first consultation, we will conduct a thorough evaluation, review your medical history, and discuss your symptoms. This may include a physical examination and, if necessary, additional diagnostic tests such as nerve conduction studies.

    It’s helpful to bring a list of your current medications, a record of your symptoms, and any relevant medical history. If you have previous medical reports or imaging related to your condition, please bring those as well.

    Yes, we accept various insurance plans. It’s best to check with your insurance provider for specific coverage details regarding consultations, diagnostic tests, and treatment options for CTS.

    Recovery can vary by individual and the severity of the condition. Typically, patients may notice improvements within a few weeks, but full recovery might take several months. We provide a detailed post-operative care plan to support your recovery process.

    Yes, we offer physiotherapy services as part of our comprehensive care for CTS. Our physiotherapists will work with you to develop a personalized rehabilitation program aimed at improving wrist strength and flexibility.

    While many patients may receive same-day treatment options, such as splinting or corticosteroid injections, surgical procedures typically require a separate appointment. Our team will discuss your treatment options during your consultation.

    Wait times for surgery can vary based on the severity of your condition, scheduling availability, and other factors. Our staff will provide you with information regarding the anticipated timeline during your consultation.

    We offer several diagnostic tests for CTS, including nerve conduction studies, electromyography (EMG), and ultrasound imaging. These tests help us assess nerve function and identify any compression in the carpal tunnel.

    Yes, prior to surgery, it is generally advised to avoid blood-thinning medications, smoking, and alcohol consumption, as these can affect healing. Our surgical team will provide specific instructions tailored to your needs before your procedure.

    Patient safety is our top priority. We follow strict protocols for surgical procedures, including pre-operative assessments, sterilization techniques, and monitoring during and after surgery to minimize risks and ensure a safe environment.

    Most carpal tunnel surgeries are performed on an outpatient basis, meaning you can go home the same day. However, if there are any complications or special considerations, an overnight stay may be recommended.