How Do You Treat Carpal Tunnel Syndrome?

Once the diagnosis of carpal tunnel syndrome has been established and underlying diseases associated with the condition have been dealt with, then it is time to treat the condition.

Medication such as acetaminophen and non-steroidal anti-inflammatory drugs can be used for symptom relief. Splinting the wrist, especially at night, helps keep the wrist straight during the night and thus decreases the pressure on the median nerve. These splints, which are available in your rheumatologist's office or at many pharmacies, may relieve symptoms, especially in milder cases.

A cortisone injection into the carpal tunnel area is often helpful in relieving symptoms for weeks to months and can be repeated. Injections should be done using ultrasound guidance. If there is an underlying disease, such as hypothyroidism (under active thyroid) or rheumatoid arthritis, causing the carpal tunnel syndrome, then treatment of the specific disease may also relieve symptoms.

Carpal tunnel syndrome occurring during pregnancy is often treated wtih splints and occasionally diuretics. These drugs should be used sparingly. Carpal tunnel symptoms usually resolve after delivery.

When the above measures fail to relieve symptoms, surgical opening of the tunnel to relieve the pressure on the median nerve, known as a carpal tunnel release, is probably indicated. In severe cases, early surgery may be considered. If there is significant muscle atrophy, surgical release is indicated over more conservative measures. However, if the carpal tunnel syndrome is very severe and has been present a long time, even surgery may not work. The surgery may be an open surgical procedure or an endoscopic procedure, and can be often done on an outpatient basis.

Nathan Wei, MD, FACP, FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland (http://www.aocm.org/). He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and consultant to the National Institutes of Health. For more info: http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html Arthritis Treatment

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