Signs and symptoms typically are numbness and tingling in the digits that are innervated by the
median nerve: thumb, index, middle, and half of the ring finger. Often the patient has pain in the
wrist and hand radiated to the elbow and is often awakened in the middle of the night and has to
massage or shake the extremely to get relief. At times, the patient drops objects that he or she
carries in the affected hand because of decreased power of grip and decreased sensation.

The condition is caused by compression of the median nerve between the carpal bones and by a
tight ligament at the wrist. Using the hand in a flexed position repetitively aggravates the
symptoms.

 

  1. The treatment is initiated by a consult with Dr. Nosti. The extremity is examined, a
    history of medical history obtained and often a nerve conduction study is recommended
    to confirm the diagnosis.
  2. Treatment options:
    • Relief of pain using a splint to keep the wrist in a neutral position and avoid
      extreme motion. This is a limited solution.
    • Local injection with cortisone may give temporary relief
    • If the symptoms appear during pregnancy they will go away or as soon as the
      swelling is relieved with delivery
      Surgical release of the compression. This is a more permanent solution.
  3. Surgery is done under sedation with local anesthetic in an outpatient setting. A small
    incision is made in the palm and the carpal ligament divided. The incision is then closed.

Q. What limitations in the function of the hand are there after surgery?

A. Recovery takes two to three weeks. A small splint is used to limit the bending of the wrist
for the first two to three weeks. The power of the grip of the hand will take some time to
return.

Q: What about pain?

A: Postoperative pain is limited, and usually pain prior to surgery is relieved even if there is
some postoperative pain that is temporary.

Q: How soon will the patient recover from the symptoms?

A: The pain usually is relieved immediately unless the symptoms have been present for a
long time. There is some discomfort around the incision. The recovery, especially the
sensation and power, depends on the duration of the compression, the patient’s age, and
associated medical conditions. The return of power of the grip, especially in lesions that
have not been present for a long time, is relatively quick. Sometimes the symptoms are
present during pregnancy. In that case, it is just a temporary problem and is relieved as
soon as the edema subsides. Again it is a good idea to seek medical treatment as soon as
the symptoms appear. The longer the duration of the compression, the longer the time of
recovery.