What is Carpal Tunnel Syndrome and How Do I Manage It?
Carpal Tunnel Syndrome is a common problem that I diagnose, provide comprehensive non-surgical care for, and manage.

It is a problem with the median nerve in the hand.

The patient presents for care with complaints of numbness and tingling in the hand. Many times the symptoms are worse at night, with driving and sometimes with repetitive hand activities. Tools that vibrate are especially suspicious for bothering our median nerves. It is common in both men and women.

Your primary care physician makes the diagnosis by history and physical exam. He/she might ask you to stretch your hands with the backs of your hands facing eachother (in a reverse prayer position) or even just applying pressure with their thumbs on your wrist on the palm side. After this you have been asked to ice your wrists and possibly wear night splints to keep for wrists straight at night. Do not wear your splints duing the day unless instructed to do so by a healthcare provider.

If you are not icing you are missing the easiest way to reduce your numbness.

Oral medications are not the best treatment. 10 minutes of ice to your wirsts palm side for 10 minutes 3-4 times a day works best...a bag of frozen peas works great!

If you are icing 3-4 times a day and using your night splints you might be a candidate for a cortisone injection into your wrist.

Your primary care physician can easily perform this simple and safe procedure.

If necessary you might be referred to the Physical Medicine and Rehabilitation Department for a ''Nerve test.'' It is called a nerve conduction study. It involves attaching electrodes to your skin and stimulating the nerves with electric shocks. If we are searching for other nerve diseases we sometimes need to perform and EMG, this involves placing a needle electrode through your skin into your muscles. This is usually not necessary to test for Carpal tunnel syndrome.

If your nerve test show ''carpal tunnel'' and you are not responding to ice, splints, and injections you might be a candidate for surgery.

This is a discussion between you and a surgeon. Your primary care doctor or one of us can refer you for a surgical opinion.

If your main hand complaint is pain without numbness it is highly unlikely that you have carpal tunnel syndrome as your only problem. Your physiatrist who performs the nerve test will discuss with you the results of the test and what we believe is the source of your problem at the time of the nerve test.

Other Hand-Arm Problems

I often see patients for a multitude of hand and arm problems.

The most common are:

1. Shoulder and/or rotator cuff problems. Make sure you are doing your exercises!
2. Tennis Elbow = lateral epicondylitis. Make sure you are doing your stretches, icing, wearing you tennis elbow splint.