Treatments and drugsBy Mayo Clinic staff
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|Carpal tunnel release|
Some people with mild symptoms of carpal tunnel syndrome can ease their discomfort by taking more-frequent breaks to rest their hands and applying cold packs to reduce occasional swelling. If these techniques don't offer relief within a few weeks, additional treatment options include wrist splinting, medications and surgery. Splinting and other conservative treatments are more likely to help you if you've had only mild to moderate symptoms for less than 10 months.
If the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome. Methods may include:
- Wrist splinting. A splint that holds your wrist still while you sleep can help relieve nighttime symptoms of tingling and numbness. Nocturnal splinting may be a good option if you are pregnant and have carpal tunnel syndrome.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may help relieve pain from carpal tunnel syndrome in the short term. There's no evidence, though, that these drugs can actually improve the carpal tunnel syndrome itself.
- Corticosteroids. Your doctor may inject your carpal tunnel with a corticosteroid, such as cortisone, to relieve your pain. Corticosteroids decrease inflammation and swelling, which relieves pressure on the median nerve. Oral corticosteroids aren't considered as effective as corticosteroid injections for treating carpal tunnel syndrome.
If carpal tunnel syndrome results from an inflammatory arthritis, such as rheumatoid arthritis, then treating the underlying condition may reduce symptoms of carpal tunnel syndrome, but this hasn't been proved.
If your symptoms are severe or persist after trying nonsurgical therapy, surgery may be the best option.
The goal of carpal tunnel surgery is to relieve pressure on your median nerve by cutting the ligament pressing on the nerve. During the healing process after the surgery, the ligament tissues gradually grow back together while allowing more room for the nerve than existed before. The surgery may be done a couple of different ways. Either technique has risks and benefits that are important to discuss with your surgeon before surgery.
- Endoscopic surgery. Carpal tunnel surgery can be done using an endoscope, a telescope-like device with a tiny camera attached to it that allows your doctor to see inside your carpal tunnel and perform the surgery through small incisions in your hand or wrist.
- Open surgery. In other cases, surgery involves making a larger incision in the palm of your hand over the carpal tunnel and cutting through the ligament to free the nerve.
In general, your doctor will encourage you to use your hand after surgery, gradually working back to normal use of your hand while avoiding forceful hand motions or extreme positions of your wrist. Soreness or weakness may take from several weeks to as long as a few months to resolve after surgery. If your symptoms were very severe before surgery, symptoms may not go away completely after surgery.
- Carpal tunnel syndrome fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm. Accessed Dec. 20, 2010.
- Carpal tunnel syndrome. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00005. Accessed Dec. 20, 2010.
- Carpal tunnel syndrome. American Society for Surgery of the Hand. http://www.assh.org/Public/HandConditions/Pages/CarpalTunnelSyndrome.aspx. Accessed Dec. 20, 2010.
- Scott KR, et al. Etiology of carpal tunnel syndrome. http://www.uptodate.com/home/index.html. Accessed Dec. 20, 2010.
- Wright PE. Carpal tunnel, ulnar tunnel, and stenosing tenosynovitis. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2008. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-03329-9..50076-3&isbn=978-0-323-03329-9&type=bookPage§ionEid=4-u1.0-B978-0-323-03329-9..50076-3--cesec9&uniqId=230418749-3. Accessed Dec. 20, 2010.
- Clinical practice guideline on the diagnosis of carpal tunnel syndrome. Rosemont, Ill.: American Academy of Orthopaedic Surgeons. http://www.aaos.org/research/guidelines/CTS_guideline.pdf. Accessed Dec. 21, 2010.
- Clinical practice guideline on the treatment of carpal tunnel syndrome. Rosemont, Ill.: American Academy of Orthopaedic Surgeons. http://www.aaos.org/research/guidelines/CTSTreatmentGuideline.pdf. Accessed Dec. 21, 2010.
- Scott KR, et al. Treatment of carpal tunnel syndrome. http://www.uptodate.com/home/index.html. Accessed Dec. 21, 2010.
- Amadio PC (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 21, 2010.