Imagine crawling into bed after a hard day’s work only to be awakened every 45 minutes by tremendous pain in your wrist and hand. This was a reality for Charlie Woods before he sought help from Dr. Andrew Foret, hand and wrist specialist at Center for Orthopaedics.
“Every night I would wake constantly throughout the night because it felt like my hand was caught in a vice,” said Woods.
Dr. Foret says this is a classic symptom of carpal tunnel syndrome, one of the most common causes of wrist and hand pain. “Although most people think of the hands when they think of carpal tunnel pain, it can affect the wrist too, and actually starts there, when the median nerve, which is on the palm side of the hand, becomes compressed by other structures in the wrist.”
Dr. Foret says the risk of developing carpal tunnel syndrome is not confined to people in a single industry or job, but it is a classic overuse injury, occurring most often in those performing repetitive-type tasks in the manufacturing, construction, clerical, sewing, finishing and cleaning industries. “Basically, anyone who often has their wrist situated at an awkward angle for extended periods of time is vulnerable to the condition.”
According to Dr. Foret, carpal tunnel syndrome usually occurs only in adults, and women are three times more likely than men to develop carpal tunnel syndrome. This may be because the carpal tunnel itself is typically smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain. Persons with diabetes or other metabolic disorders that directly affect the body’s nerves and make them more susceptible to compression are also at high risk.
If left untreated, Dr. Foret says pain from the condition becomes more severe, spreading up the arm and making it difficult to complete manual tasks, like typing on a computer, holding a hammer or gripping a hair drier.
A diagnosis of carpal tunnel syndrome involves a physical examination of the hands, wrists, arms and shoulders, along with electrodiagnostic tests to measure the electrical activity of nerves and muscles. “When muscles are active, they produce an electrical current. This current is usually proportional to the level of the muscle activity,” explains Dr. Bill Lowry, physical medicine and rehabilitation specialist with Center for Orthopaedics. He says electrodiagnostic tests are very accurate for confirming a diagnosis of carpal tunnel syndrome. “The technology has been around for a while, but it continues to improve, and today is considered more than 90 percent accurate.” The testing device resembles a desktop computer and the screening is performed in the Center for Orthopaedics’ office.
Dr. Foret says it is very important to pay attention to early warning signs – tingling, numbness and mild pain or cramping – and seek an evaluation. “If we can diagnose early, there are more options for non-surgical treatment, and we can hopefully avoid permanent damage of the median nerve, which can lead to loss of grip strength.”
This was the case for Elizabeth Self, a life-long, self-described crafter who normally spends hours sewing, doing hand stitching, painting and doing other creative projects. About two years ago, she started having tingling, pain and numbness in her hands. She saw Dr. Lowry who diagnosed her with carpal tunnel syndrome after an EMG INCS study. He recommended a wrist brace and exercises, which worked to alleviate the symptoms for many months, but her condition worsened, preventing her from doing the things she needed to do. After a follow-up exam, Dr. Lowry determined that it was time for her to consider surgical treatment. Dr. Foret performed an endoscopic carpal tunnel release on her right hand in April. Self says the relief was immediate. “I felt like I had my hand back! The recovery was short and really pain-free. It was amazing – no more numbness or pain. I’m back to using that hand just as I did before the problems started. That’s why I’m having my other hand done this month.”
Woods had the same results and has already had the procedure on both hands. “The most noticeable thing right after the surgery was the absence of pain at night. I was finally able to sleep again.”
According to Dr. Foret, endoscopic procedures have become commonplace thanks to today’s technological advances. “Using this technique for a procedure like carpal tunnel release means a shorter recovery time and a reduction in the postoperative pain.”