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Carpal Tunnel/Cubital Tunnel Treatment

Carpal Tunnel Syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area. Common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except little finger; pain and burning sensation in hand and wrist that may radiate up the arm and elbow; and weakness in hand with diminished grip strength. Exact causes of the condition are not known. However certain factors increase the risk of developing carpal tunnel syndrome and they include congenital abnormalities, repetitive motion of hand and wrists, fractures and sprains, hormonal imbalance, and other medical conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, gout, overactive pituitary gland, or the presence of a cyst or tumor in the canal.

Carpal tunnel syndrome may be treated using conservative approaches or surgery. The conservative treatments include:

  • Treating underlying medical conditions
  • Immobilization of the hand and wrist with a splint or wrist brace for 4-6 weeks
  • Rest the hand for 2 weeks or more
  • Ice packs to avoid swelling
  • Avoid activities that tend to worsen the symptoms
  • Medications such as nonsteroidal anti-inflammatory drugs, diuretics, and steroid injections.
  • Strengthening and stretching exercises once symptoms diminish

If conservative treatment options fail to resolve the condition your surgeon may recommend surgical procedure.

Carpal Tunnel Release Surgery

Carpal tunnel syndrome can be treated with carpal tunnel release surgery. Traditional surgery involves up to a 2- inch incision in the palm and wrist area, whereas endoscopic surgery involves one or two half-an-inch incisions and the use of an endoscope. During the surgery, the transverse carpal ligament will be dissected to release the pressure on the median nerve and enlarge the carpal tunnel. Your surgeon will decide which options are best for you based on your general and medical conditions.

Your surgeon may suggest you to practice certain post-operative procedures for better recovery and to avoid further complications.

  • Elevate the hand above heart level to reduce swelling
  • A splint may be worn
  • Ice packs to the surgical area to reduce swelling
  • Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering
  • Physical therapy may be ordered to restore wrist strength
  • Eating a healthy diet and not smoking will promote healing

The majority of patients suffer no complications following carpal tunnel release surgery. However some patients may suffer from pain, infections, scarring, and nerve damage causing weakness, paralysis, or loss of sensation and stiffness in the hand and wrist area.


What is Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome is a condition that is caused by compression of the ulnar nerve in an area of the elbow called the cubital tunnel.

The ulnar nerve travels down the back of the elbow behind the bony bump called the medial epicondyle and through a passageway called the cubital tunnel. The cubital tunnel is a narrow passageway on the inside of the elbow formed by bone, muscle, and ligaments with the ulnar nerve passing through its center. The roof of the cubital tunnel is covered with soft tissue called fascia. When the elbow is bent, the ulnar nerve can stretch and catch on the bony bump. When the ulnar nerve is compressed or entrapped, the nerve can tear and become inflamed leading to a variety of symptoms.

Signs and Symptoms

Signs and symptoms of Cubital Tunnel Syndrome usually occur gradually, progressing to the point where the patient seeks medical attention. Left untreated, Cubital Tunnel Syndrome can lead to permanent nerve damage in the hand. Commonly reported symptoms associated with Cubital Tunnel Syndrome include the following:

  • Intermittent numbness, tingling, and pain to the little finger, ring finger, and the inside of
    the hand. These symptoms occur more frequently at night, and with elbow bending or
    prolonged resting on the elbow.
  • Aching pain to the inside of the elbow
  • Weakness in hand with diminished grip strength
  • Diminished sensation and fine motor control in the hand causing the person to drop
    objects or have difficulty handling small objects.
  • Muscle wasting in the hand and permanent nerve damage if left untreated.

Trauma

Injury to the elbow such as fractures, dislocations, or a direct blow can cause tissue swelling which can compress the ulnar nerve within the cubital tunnel.

Meet Our Physicians – Southern Maryland Orthopaedic & Sports Medicine Center
Daniel J. Bauk, M.D.
Lloyd G. Cox, II, M.D.
Elizabeth G. Forrest M.D.
Mark H. Henderson, Jr., M.D.
Peter S. Johnston, M.D.
Michael T. Travis, M.D.
Patricia J. Turner M.D.
Lucas R. Wymore, M.D.
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