Why You Should Never Delay Treatment for Carpal Tunnel Syndrome

It all starts with a tingling in your hands, perhaps some numbness, and before you know it, your entire arm is in agony or your hand doesn’t function properly. This progression is not uncommon when it comes to carpal tunnel syndrome, or CTS, which is why seeking help sooner rather than later is so important.

At Maryland Orthopedic Specialists, orthopedic surgeon Dr. Peter Fitzgibbons specializes in treating this debilitating wrist problem in his patients in Bethesda and Germantown, Maryland. And before you let his title scare you, surgery is not the de facto treatment for this condition -- especially if you get his help early on.

Here’s a look at carpal tunnel syndrome and what measures we can take to give you full function and feeling in your hand again.

Carpal tunnel syndrome basics

Your median nerve travels all the way down your arm and into your hand through your carpal tunnel, which is located on the underside of your wrist. This important nerve controls the feeling and movement of your thumb and all fingers except your pinky.

Like any good tunnel, however, your carpal tunnel doesn’t only provide passage for your median nerve. Crowding this tight passageway, which only measures an inch wide, are nine flexor tendons that pass through, allowing your fingers to bend.

To help these flexor tendons move freely, they’re surrounded by synovium, which are tissues that provide lubrication. If your synovium swells within the tight confines of your carpal tunnel, it puts pressure on your median nerve, usually causing numbness and tingling to start.

If the swelling isn’t addressed, it doesn’t go away on its own and often becomes worse, making the numbness seem far more preferable to the radiating pain and loss of function that further compression of the nerve can cause.

Brace yourself

Since CTS is a gradual condition, this provides Dr. Fitzgibbons ample opportunity to get in there to relieve the swelling, starting out with more conservative measures.

After examining your wrist, both visually and with advanced imaging, he may also use a nerve conduction study to measure how severely your median nerve is affected. With a diagnosis in hand, he can determine the best course of action.

To start, a simple brace may be the answer to your problem. By immobilizing your wrist into a straight or neutral position, a brace takes the pressure off your nerve. This also allows time for the swelling to go down.

Swelling is tricky to deal with because it compounds easily and it’s hard to avoid. Think, for example, about biting the inside of your mouth. Once you do that, your mouth swells and then it becomes almost impossible not to keep biting down or irritating the area, making the problem ever worse.

The same holds true with CTS. By keeping your wrist immobile, Dr. Fitzgibbons allows the swelling to come down by reducing the activity in the area. In conjunction with the brace, the doctor usually recommends some physical therapy exercises, anti-inflammatory medications, and changes in your hand usage.

The case for surgery

While Dr. Fitzgibbons is often able to treat your CTS without surgery, if your condition is unresponsive, surgery may prove to be your best option. If your CTS continues unchecked, it can lead to irreversible muscle and nerve damage in your thumb.

Now, here’s the good news -- CTS surgery is very simple, and Dr. Fitzgibbons performs it on an outpatient basis. The goal of the surgery is to release your carpal tunnel. To do that, Dr. Fitzgibbons cuts the ligament that forms the roof of the tunnel.

This surgery can be done endoscopically or through a very small incision along the palm of your hand, and it often provides quick relief. You may have some work to do to reactive and heal your nerve, but with more room in your carpal tunnel, your nerve has the freedom to heal properly.

If you still have questions about carpal tunnel syndrome, please don’t hesitate to call us, or use the online form on this website to schedule an appointment.


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