Since carpal tunnel syndrome develops over time, urgent care is usually not necessary. However, if you are experiencing unbearable pain, call your doctor and follow his or her instructions.
The simplest treatment is to stop doing the actions that are putting stress on your wrists. If this is not possible, warm up your muscles before beginning a repetitive task and rest repeatedly while on the job to relax affected muscles. Breaks can be as short as 10 seconds, or as long as 10 minutes per hour in more severe cases or in people whose jobs involve a great deal of repetitive motion.Many people benefit from wearing a wrist splint or brace at night. This can help relieve pressure in the affected wrist.
Your doctor is the best source of information on the drug treatment choices available to you.
If symptoms persist even after drug treatment and rest, surgery may be recommended to release pressure on the median nerve. Surgery for carpal tunnel syndrome is called a “release” because it cuts the volar carpal ligament, thus releasing the median nerve from pressure. For this type of surgery, the doctor may numb your wrist with a shot, or may choose to numb your entire arm. If surgery is expected to take more than 30 minutes, general anesthesia will probably be used.
Surgery can be complicated by an infection or blood clot at the site of the incision or by injury to the nerves serving the thumb or palm; however, such complications are rare.
After surgery, your physician will wrap your hand in a dressing meant to reduce the movement of your fingers and wrist, and will give you specific instructions to follow.
You may be asked to elevate your hand while sleeping to help reduce pain. You may also be asked to perform motions with your wrists and fingers, starting a few days after surgery, to prevent stiffness. Stitches are usually removed after about 10 days.
Recovery time varies, depending on your age and the severity of the initial condition .
You may not be able to return to normal activities until several weeks after surgery. Most people regain full use of the affected hand after 6 to 10 weeks, but recovery can take up to 4 months in severe cases. Limitations after surgery will also depend on whether you had surgery on your writing hand. Most people are able to drive within 1 to 2 days of surgery, are able to write within to 4 to 6 weeks, and recover full grip strength in 10 to 12 weeks.
Even if your surgery is successful, it is generally a good idea to try to avoid activities that put excessive strain on your wrists.
After surgery on one wrist, patients with two affected wrists often report that the problem has resolved on both sides.
Some physicians may recommend dietary changes to help reduce or control pain. You may be asked to limit your intake of protein and foods that deplete stores of vitamin B6, such as sugars, caffeine, and processed grains. You may also be asked to eliminate foods that contain yellow dyes, and to include whole grains, seeds, nuts, soybeans, liver, fresh salmon, cod, brewer's yeast, molasses, wheat bran, and other vitamin B-rich foods in your diet. You may also be asked to supplement your diet with vitamin B6, vitamin B complex, magnesium, essential fatty acids, folic acid, and thyroid hormone.
Tinctures of herbs known for their anti-inflammatory properties, such as meadowsweet and willow bark, may be recommended.
Controlled studies are being performed to determine whether acupuncture may be useful in the treatment of carpal tunnel syndrome; however, results are not yet available.
Recovery time for carpal tunnel surgery, as for all types of surgery, may be longer in patients with diabetes; carpal tunnel syndrome is more likely to recur in patients with diabetes as well.
Treatment of carpal tunnel syndrome is successful in most cases. After surgical treatment, fewer than 5% of patients have recurring symptoms. However, about 1% of patients with carpal tunnel syndrome experience permanent injury from the condition even after treatment.
After treatment, avoid or minimize activities that put stress on the wrists. If these activities must be continued, resume them with preventive measures in mind.
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