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Carpal Tunnel Syndrome: Symptoms
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Carpal tunnel syndrome symptoms usually include pain, numbness, tingling, or a combination of the three. The numbness or tingling most often takes place in the thumb, index, middle, and ring fingers. The symptoms usually are felt during the night but ... may be noticed during daily activities such as driving or reading a newspaper. Patients may sometimes notice a weaker grip, occasional clumsiness, and a tendency to drop things. In severe cases, sensation may be permanently lost and the muscles at the base of the thumb slowly shrink (thenaratrophy), causing difficulty with pinch.
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It is critical to begin treating early phases of carpal tunnel syndrome before the damage progresses. A conservative approach to CTS is the first step in treating this disorder, which may include corticosteroid injections and splinting. Nevertheless, relapse is common and studies suggest that surgery is a better option for severe CTS. In one study, 89% of patients who had conservative treatments suffered a recurrence of symptoms within a year. Conservative treatment works best in men under 40 and least well in young women. The conservative approach is ... most successful in patients with mild carpal tunnel syndrome.
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Surgery to correct carpal tunnel syndrome has high success rate, especially using endoscopic surgery techniques. Up to 90% of patients were able to return to their same jobs after surgery. [37][38][39] In general, endoscopic techniques are as effective as traditional open carpal surgeries,[40][41] though the faster recovery time typically noted in endoscopic procedures may be offset by higher complication rates.[42][43] Success is greatest in patients with the most typical symptoms. The most common cause of failure is incorrect diagnosis, and it should be noted that this surgery will only fix carpal tunnel syndrome, and will not relieve symptoms with alternate causes. Recurrence is rare, and apparent recurrence usually results from a misdiagnosis of another problem. Complications can occur, but serious ones are infrequent to rare.
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In 1988, 2.8 million people reported symptoms to their doctors that they believed were those of carpal tunnel syndrome. In a 1998 British study, experts estimated that between 7% and 16% of the population experience CTS. The incidence appears to be increasing. People over age 54 were at higher risk than younger adults. The wide variation in severity and the difficulty in diagnosis make it hard to pinpoint specific figures.
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The most important step in controlling carpal tunnel syndrome is to maintain good overall health and fitness. However, if you suspect that certain activities at your workplace are helping to cause tingling, numbness, weakness, and pain in your fingers or hand, make some changes now. For example, prolonged and forceful finger movement or using vibrating machinery may contribute to symptoms of carpal tunnel syndrome. Talk to your human resources department about different ways of doing your job, changes in your equipment, or having an ergonomic consultation if you notice these symptoms. For more information, see the topic Office Ergonomics.
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When carpal tunnel syndrome is just one symptom of a more serious disorder, the results of surgery are not always very good. The difficulty is not in recovering from the operation, but in recovering the ability to return to work, especially to the same job that caused the disorder to occur. Whether or not true carpal tunnel symptoms recur in these patients, many continue to have pain and are unable to use their hands to any great extent.
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