Featuring Dr. Bertrand Perey, MD, Orthopaedics Video Title: Carpal Tunnel Syndrome Symptoms and Treatment Options Duration: 3 minutes, 16 seconds

When you start developing symptoms of carpal tunnel syndrome, and your diagnosis has been confirmed by your family physician, sometimes an added diagnosis is getting something called a nerve conduction study, where you’re sent to a neurologist to test the level of slowing of that nerve.

That test will often come back positive, and it will give you some idea of the degree of compression; not that that’s related, necessarily, to your symptoms, but it does help confirm the diagnosis.

Not all doctors will need a positive nerve test to make the diagnosis if you have classic symptoms of carpal tunnel syndrome. Early in the disease, in the entity, when you start having numbness in your hands, most physicians will recommend bracing at nighttime. It will keep your wrist in a straighter position.

They may ask you to avoid positions of extreme extension or flexion of your wrist joint during the daytime at work, or at hobbies or sports that you do.

And most commonly this is done with a brace, they can ask you to maybe avoid certain activities that may involve a lot of prolonged gripping. It’s a springtime, you’re involved in house care, gardening, you’re doing a lot of that, your symptoms are getting worse, they may advise you “It’s okay; just hold off on that a bit, it may settle down.”

They may put you on some anti-inflammatories to settle some of your symptoms, and some doctors will actually inject cortisone into your carpal canal that may help you temporarily.

The problem is, by and large, a progressive problem. So you may have mild symptoms for one day, and worse another, and month-to-month it may change. But the natural course of this is over years it will usually get worse.

That doesn’t mean you need an operation for this, or you need to run to your doctor, but just understand the natural course is for it to get worse.

Most of our allied health people will help you manage the symptoms, and perhaps delay the need for surgery. But ultimately you end up having symptoms on a daily basis, you probably want to see your doctor, to seek attention from a surgeon who deals with carpal tunnel syndrome.

The principles of surgery are simply to release this ligament that we talked about earlier on. It literally is about two centimeters in length, and it involves an incision to cut it. I make the analogy that if your waist is 40 inches in diameter and you have a 28 inch belt, what you need to do is cut the belt. It makes you feel better.

So this is a tight belt around your wrist. Just cutting the belt in itself will often relieve all of the symptoms of numbness, pain and issues that you’re having related to the carpal canal.

Now, there are basically two ways of cutting this tunnel. You can go right over the top with a small blade; a small incision is made where the ligament is cut. Or there’s another technique where people can go in through a camera from the inside of the tunnel and cut it from inside-out.

This is called endoscopic surgery. The results of both of these techniques are essentially the same, and the outcomes are exactly the same.

If you think you have carpal tunnel syndrome, you should seek attention from your family doctor to confirm the diagnosis and seek treatment.

Presenter: Dr. Bertrand Perey, Orthopaedic Surgeon, New Westminster, BC

Local Practitioners: Orthopaedic Surgeon