How to Prevent and Treat Carpal Tunnel Syndrome in the Wrist and Shoulder

John V. Tiberi';

By John V. Tiberi

Posted on July 1st, 2015 in Orthopedics

Carpal tunnel syndrome is often a “desk job” injury, but developing this condition is not confined to people working in a single industry or job.

Women have a significantly higher risk than men to develop this condition, but all adults are susceptible.

The carpal tunnel is a passageway on the palm side of the wrist connecting the forearm to the middle palm.

It houses the median nerve and tendons and is a narrow passageway of ligament and bones at the base of the hand.

Carpal tunnel syndrome or CTS occurs when the median nerve becomes pressed or squeezed at the wrist.

This causes numbness, tingling, and weakness in the hand. CTS is an inflammatory disorder caused by repetitive stress, a medical condition, or physical injury.

How Is CTS Diagnosed and Treated?

As with any medical condition, early diagnosis and treatment are important to avoid permanent damage to the median nerve. Before going on with more detailed examinations, a physical examination is required to determine whether your problems are related to daily activities or an underlying disorder.

Your wrist will be examined for warmth, discoloration, tenderness, and swelling. Specific tests carried out for diagnosing CTS include:

  • the Tinel test
  • the Phalen (wrist-flexion) test
  • electrodiagnostic tests: nerve conduction study, electromyography, ultrasound imaging, MRI

Treatment should begin as early as possible after CTS is diagnosed, but underlying causes such as diabetes and arthritis should be treated first. Treatment for carpal tunnel syndrome can be both non-surgical and surgical.

Non-surgical treatments include:

  • alternative therapies: chiropractic care, acupuncture, yoga
  • drugs: non-steroidal anti-inflammatory drugs, orally administered diuretics, corticosteroids, vitamin B6
  • exercise: stretching and strengthening exercises

Surgery for carpal tunnel syndrome is one of the most commonly performed in the US and is generally recommended if symptoms last for 6 months.

During surgery, the physician severs the band of tissue around the wrist to reduce pressure on the median nerve. The procedure is done under local anesthesia and does not require an overnight stay at the hospital.

The traditional procedure used to correct CTS is called open release surgery, which consists of making an incision up to 2 inches in the wrist and cutting the carpal ligament to enlarge the carpal tunnel. However, endoscopic surgery allows faster functional recovery and less postoperative discomfort.

Non-Surgical Treatments for Shoulder Pain

Shoulder pain does not always require surgical intervention. In fact, surgery should be the last resort. Before you consider any non-surgical treatments for shoulder pain, it is best to understand the causes of your pain and what potential treatments are available to you.

What Causes Shoulder Pain?

Shoulder problems are often caused by the breakdown of soft tissues in the region. As people get older, overusing the shoulder can cause soft tissue to break down faster. Also, playing sports and manual labor contribute to a large number of shoulder problems.

Pain can be felt in one small spot, in a larger area, or up and down the entire arm. However, pain that travels along nerves to the shoulder might not be caused by a breakdown of tissue. This type of pain can be caused by:

  • heart disease
  • liver disease
  • gallbladder disease
  • cervical spine disease

If you experience nerve pain, make an appointment right away with your doctor so he or she can properly diagnose the cause.

Typical Non-Surgical Shoulder Pain Treatment

One option to treat shoulder pain is to use ice to reduce inflammation by compressing the ice on the affected area at 20-minute intervals. You can also reduce inflammation by keeping your shoulder elevated above the heart, and once the inflammation has been reduced, you can promote blood flow to the area by using heat.

Medications are often prescribed to help patients live their life with little to no pain at all. Common medications are:

  • aspirin-free pain relievers
  • anti-inflammatory drugs
  • corticosteroids
  • disease modifiers
  • sleep medications

Other Types of Treatment

Exercise helps us in all aspects of our life, and, done regularly. It can help by lessening shoulder pain, increasing movement, improving strength and flexibility, and reducing fatigue.

Physical therapy can help you ease your shoulder pain – seek a physical therapist to work with you to create a personalized exercise program that best fits you.

Other treatment options include:

  • occupational therapy
  • heat/cold therapies
  • hyaluronic acid injections
  • nontraditional and alternative treatments
  • anesthetics with corticosteroid medicine injections

As a leading surgical hospital, Marina del Rey Hospital is committed to enhancing the lives of all patients by providing quality care. A team of nationally recognized physicians and support staff is always ready to treat even the most challenging medical conditions and help patients regain their health.