Orthopedics

OSPI offers the top orthopedic surgeons in Gilbert AZ and the East Valley. Drs. Mahoney, Macqueen, Stewart and Clouse offer minimally invasive General, Sports and Joint Replacement expertise.

Physical Therapy

Whether you are pre or post-operative, OSPI’s East Valley physical therapy team works with you on both active and passive treatments. Your will be in the best hands with our licensed physical therapists!

Chiropractic

The Gilbert chiropractors at OSPI offer a plethora of nonoperative pain relief options such as manipulations, laser therapy, physiotherapy and electrical stimulation.

Family Practice

OSPI offers comprehensive family practice services including allergy testing, BHRT, medical weight loss, aesthetics and full check ups.

Medical Weight Loss

Patients routinely experience dramatic, healthy weight loss with the customized programs at OSPI. The programs combine nutrition, exercise and prescription weight loss options.

Performance Training

OSPI’s integrated team of healthcare providers work with both amateur and professional athletes to maximize one’s performance with sport specific programs.

Pain Management

OSPI’s Board Certified, Fellowship Trained pain doctor offers both medication management and interventional procedures with exceptional outcomes!

Carpal Tunnel Syndrome

FAQs on Carpal Tunnel Syndrome

 

Carpal tunnel syndrome is the most frequently occurring entrapment neuropathy to impact the upper extremity. At least one in every 20 people repetitively using hands and wrists as part of his or her occupational task faces the risk of the disorder. Even in general population, at least one percent are diagnosed with the syndrome.

What is carpal tunnel syndrome?

Carpal tunnel syndrome refers to pain, tingling sensation, and weakness in the hand traced to the compression of the median nerve as it passes through the wrist. The median nerve originates at brachial plexus, a network of nerves just above the armpit and passes down to the hand. After running along the anterior side of the forearm, it enters the hand at the carpal tunnel, a small passageway, near the wrist.

The nerve provides sensation to upper extremities. When the median nerve is compressed or squeezed in the small tunnel due to any disorder or anatomical structures, the hand and fingers feel numbness and pain leading to carpal tunnel syndrome.

What is carpal tunnel? Why is it important?

The carpal tunnel is a narrow passageway located near the wrist on the palm side. The wrist bones on both side of the carpal canal are connected by a ligament above giving it a shape of a tunnel. Nine long flexor tendons and the median nerve pass through the tunnel connecting fingers and the palm with the forearm.

How does carpal tunnel syndrome occur?

Carpal tunnel syndrome occurs due to any condition that leads to compression of the median nerve in the area. The carpal tunnel is a small and narrow subway surrounded by bones and ligaments. Nine flexor tendons pass through it along with the median nerve, which carries sensation and impulses to small hand muscles responsible to move the upper extremities.

The median nerve is compressed in this narrow tunnel due to swelling and degeneration of tendons passing alongside. Selling causes the irritated tendons to be inflamed or thicken. This puts pressure on the nerve causing its squeezing. Also wrist movements often impact the size of the carpal tunnel. Wrist flexion and extension moves push its bony walls reducing the width. This may entrap the median nerve within the constricted tunnel.

When the median nerve is squeezed or compressed, pain, weakness, and numbness are experienced in the hand as the nerve finds it difficult to carry sensation to fingers and thumb. The condition is named as carpal tunnel syndrome.

What are symptoms of carpal tunnel syndrome?

  • Numbness or tingling sensation in the hand
  • Electric shock-type feeling in upper extremities
  • Weakness and pain in thumb, index, and long fingers
  • Pain radiating to the forearm
  • Worsening symptoms often at night
  • Loss of grip strength
  • Atrophy of the thumb muscles

What are causes of carpal tunnel syndrome?

The syndrome onsets when the median nerve is squeezed, compressed, or irritated due to

  • Inflamed or swelled nine flexor tendons
  • Swelling of synovium tissues around these tendons
  • Injury to the wrist causing pressure on the tunnel structure
  • Hereditary undersized carpal tunnel
  • Wrist overuse, sprain, or fracture
  • Hormonal changes in pregnant women
  • Degeneration of tendons and bony wrist structures
  • Conditions, such as thyroid disorder, diabetes, and rheumatoid arthritis,
  • Thickening of the transverse ligament above the carpal tunnel

Who are at risk of having carpal tunnel syndrome?

People above 60 years are more frequently diagnosed with the problem. Those with obesity, diabetes, wrist structural abnormality, and hypothyroidism face increased risk of it. Computer professionals, musicians, and workers working in the packing or assembling units are also at the danger of being diagnosed with carpal tunnel syndrome.

How is carpal tunnel syndrome diagnosed?

Doctors check symptoms and examine muscular weakness in the upper extremities. Patients are asked to bend and hold their wrists in particular postures to highlight the onset of tingling sensation. Mild pressure is put on the median nerve to make sure it is the reason of the condition. X-ray may be conducted to scrutinize the wrist condition. Electrophysiological tests are there to study if the median nerve is unable to perform its function.

What are available methods to treat carpal tunnel syndrome?

  • Nonsurgical Treatment

Self-care: Exercises, rest, and change of activities provide relief from the disorder at the initial stage. It also allows the inflamed tendon to stay away from further pressure and overcome inflammatory causes.

Medication: Anti-inflammatory drugs reduce swelling in the tendons that squeeze the median nerve and subdue pain.

Brace or splint: Using these devices helps keep the wrist remain in a neutral position that assists in the healing process. It also prevents irritation of the median nerve traced to wrist curling at night.

Steroid injections: Corticosteroid directly injected to the wrist tunnel to alleviate swelling inside and provide long-term pain relief.

  • Surgical Treatment

Severity of carpal tunnel syndrome symptoms necessitates surgical intervention. It involves bifurcation of the transverse ligament that connects the wrist bones and creates a roof above the carpal canal. This allows the tunnel to have more space and also frees it from pressure of side bones.

References

Concannon M J, Puckett C L. The Incidence of Recurrence after Endoscopic Carpal Tunnel Release. Plastic and Reconstructive Surgery: Volume 105(5) April 2000, 1662-1665

Carpal Tunnel Syndrome Fact Sheet, National Institute of Neurological Disorders and Stroke

Nordqvist, Christian. “What is carpal tunnel syndrome? What causes carpal tunnel syndrome?.” Medical News Today. MediLexicon, Intl., 15 Sep. 2014. Web.

McCartan, B; Ashby, E; Taylor, EJ; Haddad, FS (Apr 2012). “Carpal tunnel syndrome.”. British journal of hospital medicine (London, England : 2005) 73 (4): 199–202.

Lazaro, R (1997). “Neuropathic symptoms and musculoskeletal pain in carpal tunnel syndrome: Prognostic and therapeutic implications”. Surgical Neurology 47 (2): 115–7

Katz, Jeffrey N.; Simmons, Barry P. (2002). “Carpal Tunnel Syndrome”. New England Journal of Medicine 346 (23): 1807–12

Piazzini, DB; Aprile, I; Ferrara, PE; Bertolini, C; Tonali, P; Maggi, L; Rabini, A; Piantelli, S; Padua, L (Apr 2007). “A systematic review of conservative treatment of carpal tunnel syndrome”. Clinical rehabilitation 21 (4): 299–314.

Clinical Practice Guideline on the Treatment of Carpal Tunnel Syndrome (PDF). American Academy of Orthopaedic Surgeons. September 2008

LeBlanc KE, Cestia W. Carpal Tunnel Syndrome, Am Fam Physician. 2011 Apr 15;83(8):952-958.

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