Wednesday, August 15, 2012

Why Do My Fingers and Hand Tingle and Hurt?

There may be several causes but the most common cause is carpal tunnel syndrome.  The most common symptoms include numbness, a tingling feeling, and pain in the hand on the palm side involving the thumb, index finger, long finger, and part of the ring finger.

What Causes Carpal Tunnel Syndrome?
A nerve (the median nerve) runs through a tight space in the wrist along with tendons.  This space is called the carpal tunnel and doesn’t allow much extra room for swelling and inflammation around the nerve.  This causes the nerve to be compressed, which creates the symptoms we just reviewed.

What Are The Most Common Symptoms of Carpal Tunnel Syndrome?
Most patients will have the numbness, tingling, and pain in the fingers on the thumb side of the hand.  In addition, most symptoms are worse with activity such as driving or using the hands for an extended period of time.  Many patients also note that their symptoms are worse at night and they wake up and let their arm hang over the side of the bed or reposition their hand to try to relieve the symptoms.

How Do I Know It’s Carpal Tunnel Syndrome?
Often a good physical exam can help clarify the diagnosis of carpal tunnel syndrome.  The doctors at SPBJ will assess the hand for loss of muscle strength or tone, evaluate for decreased sensation, and also evaluate if tapping or compressing the area around the nerve worsens symptoms.  In addition, tests such as nerve studies will help confirm if the nerve is compressed by showing that the nerve signals across the wrist are abnormal or delayed.

How Do We Fix Carpal Tunnel Syndrome?
In mild cases the doctors at SPBJ will start with conservative treatment like anti-inflammatories and a wrist brace.  If symptoms are more advanced, then a steroid injection can be helpful for some patients.  If symptoms have been present for a longer time and tests show more advanced compression at the nerve, then carpal tunnel release surgery may be a good option.

How Does the Carpal Tunnel Release Surgery Work?
It’s relatively simple in that we want to relieve the pressure on the nerve by decompressing the space around the nerve.  A small incision is made in the area and the tight band of tissue around the nerve and tendons is released.  The surgery is an outpatient surgery.  The patient goes home that day with a bandage around the incision and gradually returns to activity over several weeks as the incision heals.

Written by Dane Glueck, M.D.


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