What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) occurs when the median nerve becomes compressed as it passes through the carpal tunnel — a narrow passageway in the wrist formed by bones and ligaments. The median nerve controls sensation in the thumb, index, middle, and part of the ring finger, as well as muscle function at the base of the thumb.
When this nerve is compressed, patients experience the hallmark symptoms: numbness, tingling, and pain in the hand and fingers, often waking them at night. Left untreated, the condition can progress to permanent nerve damage and weakness.
Symptoms
- Numbness or tingling in the thumb, index, middle, and ring fingers
- Nighttime hand pain that wakes you from sleep
- Weakness when gripping or pinching
- Dropping objects unexpectedly
- Burning or aching pain radiating up the forearm
- Feeling of swollen fingers even when no swelling is present
Causes & Risk Factors
Carpal tunnel syndrome results from increased pressure within the carpal tunnel. Common contributing factors include repetitive hand and wrist motions, wrist anatomy that runs in families, pregnancy and fluid retention, diabetes, thyroid disorders, rheumatoid arthritis, previous wrist fractures, and obesity.
Diagnosis
Dr. Richards uses clinical examination and electrodiagnostic testing (nerve conduction study/EMG) to confirm carpal tunnel syndrome and assess severity. This guides the most appropriate treatment plan and predicts surgical outcomes.
Non-Surgical Treatment
- Night splinting — keeping the wrist neutral to reduce nighttime symptoms
- Corticosteroid injections — reduce inflammation within the tunnel
- Activity modification — ergonomic adjustments to reduce repetitive strain
- NSAIDs — for pain and inflammation management
Surgical — Carpal Tunnel Release
When conservative treatment fails or nerve damage is progressing, carpal tunnel release surgery is highly effective. Dr. Richards performs both open and endoscopic carpal tunnel release depending on patient anatomy. The procedure divides the transverse carpal ligament, immediately relieving pressure on the median nerve. It is performed as an outpatient procedure under local anesthesia, with most patients returning to light activity within days.
Recovery
Most patients notice significant improvement in nighttime symptoms within days of surgery. Full recovery of grip strength and sensation typically occurs over 3–6 months.