Conservative Treatments

It’s always best to address Carpal Tunnel Syndrome treatments conservatively first! Surgery is not always necessary for carpal tunnel syndrome. With a conservative approach it’s best to focus on improving and maintaining muscle, tendon, joint, and nerve mobility. It’s also important to think about the types of activities that you do that lead to increased symptoms. Modify those activities in a way that puts less stress on the wrist and hands to help reduce any occasional flare ups.

What causes flare ups? Repetitive movements, excessive weight bearing, and general overuse of the wrist and hand. There are several adaptive tools available to help with daily activities that decrease the stress on your body. Think about those difficult tasks, and search for common tools online that help make those tasks easier!

The most common adaptive tools involve jar openers, standing desks, ergonomic keyboards, and even something as simple as a commercial wrist brace.

Injections

Corticosteroid injection is a more invasive form of conservative management, and is often combined with typical stretches and nerve glides. This helps reduce inflammation of the tissues which reduces pressure on the carpal tunnel. According to NCBI (2014), symptoms improve within the first 2-4 weeks of the initial injection when combined with therapy exercises. In a group of 100 people who were studied, 75 reported improved symptoms after the injection!

Side effects are minimal. The initial injection is uncomfortable, and can cause soreness for a few days at the injection site. Infections are always a possibility, but very rare, and damage to the median nerve is also rare. 1/1000 individuals report nerve damage caused by the injection (NCBI, 2014). This is a temporary fix though, which is why it’s important to combine daily stretches with the injection to reduce inflammation and ensure proper maintenance of the wrist and hand!

Surgical Intervention

There are two surgical techniques that are most often used in carpal tunnel releases. Endoscopic and Open. These have both been proven to be very effective. Most individuals report improved symptoms the same day as the surgery! The open technique is more involved. This gives the surgeon a chance to not only release the transverse carpal ligament, but to also inspect and if needed clean any fibrotic tissue that has developed on the nerve.

Endoscopic Technique

Open Technique

References

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Carpal tunnel syndrome: How effective are corticosteroid treatments? 2014 Nov 5 [Updated 2017 Nov 16]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279598/