Frequently Asked Questions about Carpal Tunnel Syndrome
Is carpal tunnel syndrome contagious?
Answer: No. It is a nerve entrapment disorder developmentally related to being born with a small canal within the wrist which gets even tinier as one ages as the bones of the wrist enlarge compressing the enclosed nerve.
My hands feel cold all the time, especially when I am exposed to cold weather. Is this a symptom of carpal tunnel syndrome?
Answer: No. Cold intolerance relates to blood flow. Hand circulation is independent of the two nerves predominantly affecting the hand, median and ulnar nerves. Arteries do not enter the hand via the carpal tunnel, so they are not subjected to the pressure on the compressed nerve in this situation with carpal tunnel syndrome. The most likely diagnosis is Raynaud’s syndrome wherein there is hyperactivity of the nerves going into the muscles of the blood vessels to the hand causing over-constriction and reduced blood flow. We have treatment for this. Contact us.
Other people in my family (mother and sister) have had CTS. Does this put me at increased risk for developing it?
Answer: Absolutely. Numerous research studies have confirmed there is a strong familial tendency within families for a subsequent generation to have members with carpal tunnel syndrome. In fact, the largest study presented at an American Society of Surgery of the Hand meeting in about 2001 computed a 50% chance that if your mother or father had carpal tunnel syndrome you will develop it. Thus, there is a chance of up to 50% or more that each child born in a family will develop carpal tunnel syndrome. There are about 20 articles in the peer-reviewed medical literature confirming the strong genetic relationship to carpal tunnel syndrome within families. Most doctors are not aware and have not read this literature even though it is available for them.
My small and ring fingers go numb frequently especially when I try to hold my phone. Is this CTS?
Answer: No. Numbness in the small and ring fingers (ulnar two digits) are because of malfunctioning of the ulnar nerve. The situation you are describing is most likely cubital tunnel syndrome, or symptoms from pressure on the ulnar nerve at the elbow. It is less likely that you will have pressure on the ulnar nerve at the wrist and sometimes it can occur in both places. With physical examination and nerve conduction study we can confirm the problem.
How can I prevent developing carpal tunnel syndrome?
Answer: Since you can’t determine who your parents are and it’s a genetic trait you just have to wait and see if you develop the symptoms. There is a sizable percentage of people who don’t go on to develop the frank syndrome even though they have the underlying pressure problem. This can even be picked up on a nerve conduction test before symptoms develop. We normally only treat the people who are symptomatic. People with confirmed median nerve dysfunction at the wrist which can be determined by nerve conduction study should really not take on employment with powerful vibratory tools or having to do a lot of work above shoulder level since this is likely to bring on the symptoms of the underlying problem. The savvy employer would know this and screen their employees such as meat packing plants and factories that require very vigorous use of one’s hands for packing or processing products.
What are the odds of non-surgical treatment curing carpal tunnel syndrome?
Answer: Less than one in five of the people who come in with carpal tunnel syndrome will get relief with nonoperative intervention. For the most part that is only going to occur in the person who is taken away from the activity that they believe is precipitating the symptoms. In the event that symptoms don’t go away, surgery is still indicated. In my personal experience almost 100% of the people who come in with carpal tunnel syndrome need surgery. The science is overwhelming that the problem is age and genetic-related and related to being born with a small carpal tunnel and possibly nerves that are more sensitive to pressure. This situation worsens after age 30 and probably peaks in the mid-40s for most people.
Is there a benefit in getting an MRI scan of my wrist?
What role does ultrasound have in the detection and treatment of carpal tunnel syndrome?
Answer: This is a research tool. Ultrasound data comes out and is looking at shades of gray. The interpretation is very subjective. It is not objective like measuring the speed of nerve conduction with a nerve conduction test. You really can’t determine how the nerve is functioning.
What role does physical therapy have in the treatment of carpal tunnel syndrome?
Answer: In my opinion, none with the exception of the rare person who has unusual pain after surgery. In my experience this is less than 1 in 200 or 300.
Are diabetics more likely to develop carpal tunnel syndrome?
Answer: It does appear that people with diabetes are more likely to develop nerve entrapment at the wrist, the elbow and certainly in the ankle (tarsal tunnel syndrome). Fortunately, diabetics respond to decompressive surgery just as well as non-diabetics, as long as the nerves are still physiologically in good condition.
What are bad prognostic signs in a person who develops carpal tunnel syndrome?
Answer: Continuous night and day numbness, i.e. 24/7. Advanced arthritis of the neck (cervical spondylosis). Absence of nerve action potential on nerve conduction study with muscle wasting on physical exam is probably the worst finding. It is still unclear how much diabetes has in the prognosis of a person with carpal tunnel syndrome since the main thing is the need to take the pressure off the nerve.
What jobs are at the highest risk for a person to claim their carpal tunnel syndrome is job-related?
Answer: Low-paid, repetitious, mundane work has a strong correlation between low socioeconomic status and attributing problems to one’s job even though there is probably a scientific relationship.
My fingers hurt and snap. The symptoms are worst in the morning. Is this a sign of carpal tunnel syndrome?
Answer: No. You are describing trigger digit also known as tenovaginitis stenosans. This occurs in the same individual who is genetically inclined to get carpal and cubital tunnel syndrome, de Quervain’s tendinosis, basilar thumb arthritis and tennis elbow. Thus, the doctor will check you for each of these conditions if you come in for consultation.
Can carpal tunnel syndrome include pain or numbness all the way to my shoulder?
Answer: Yes. There are five articles in the English literature in the past 40 years demonstrating that a person may come in with the only sign of carpal tunnel syndrome being pain in the neck or shoulder that won’t go away until the pinched nerve at the wrist is decompressed with minor surgery.
Braces, topical cream, and electrical stimulation are popping up all over the internet. What, if any, benefit can be expected from these for nerve entrapment?
Answer: None. They are placebos deceptively offered by unethical businesses trying to capitalize off the ignorance of the public. Only surgery will solve carpal tunnel syndrome and, if caught early, bracing will prevent progression and eliminate symptoms of cubital tunnel syndrome while minor surgery is necessary for many patients that present with a pinched nerve at the elbow.
Are exercises beneficial in prevention or treatment of carpal tunnel syndrome?
Answer: No. There has been some suggestion that it might be but it doesn’t make any sense at all and there is no proof of benefit. Certainly if exercise was beneficial in eliminating or preventing carpal tunnel syndrome then any possible claim by a worker that there is an association between activity and their job is completely eliminated.
How fast do carpal tunnel symptoms resolve after carpal tunnel release whether it is open or endoscopic?
Answer: It depends on what the symptom is. Seven out of ten people come in awakening at night with numbness or pain in the hand; that goes away immediately after surgery. Some soreness in the wrist is going to persist after surgery because of the surgery itself. Clumsiness and dropping things depends on how bad the person’s numbness is and typically that improves within days to weeks. Carpal tunnel syndrome does not cause weakness. If a person has weakness it is due to either pain or another nerve entrapment, though one should not expect any effect on their strength based on carpal tunnel release.