Carpal Tunnel Syndrome - Treatment Overview

Treatment Overview

The goal of treatment for carpal tunnel syndrome is to allow you to return to your normal function and activities and to:

• Address other health conditions if they are aggravating your symptoms of carpal tunnel syndrome.
• Reduce any inflammation of tissues in the wrist that puts pressure on the median nerve.
• Determine the causes of your carpal tunnel symptoms. You can then identify whether there are activities for you to avoid or do differently and ways you can help prevent the condition.
• Prevent nerve damage and loss of muscle strength in your fingers and hand.

Treatment for carpal tunnel syndrome is based on the seriousness of the condition, whether there is any nerve damage, and whether other treatment has helped. Treatment options include treatment without surgery (nonsurgical treatment) or with surgery.

• If treated early, carpal tunnel symptoms usually go away with nonsurgical treatment.
• If your symptoms are mild, with occasional tingling, numbness, weakness, or pain, 1 to 2 weeks of home treatment are likely to relieve your symptoms.
• If home treatment does not help, or if your symptoms are more severe (including the loss of feeling in your fingers or hand, or the inability to perform simple hand movements such as holding objects or pinching), have your health professional examine you and recommend treatment.

Nonsurgical treatment

If your symptoms are not severe, expect your health professional to recommend nonsurgical treatment to see whether symptoms improve. Nonsurgical treatment includes:

• Evaluating any other medical conditions that might contribute to carpal tunnel syndrome, and changing your treatment for those conditions if necessary.
• Changing or avoiding activities that may be causing symptoms, and taking frequent breaks from repetitive tasks.
• Wearing a wrist splint to keep your wrist straight, usually just at night. See an illustration of a wrist splint.
• Using nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation. Although studies have not shown NSAIDs to be effective for carpal tunnel syndrome, they may help you to relieve symptoms.
• Doing exercises to stretch and strengthen the muscles in the hand and arm.
• Learning ways to protect your joints as you go through your daily activities.

In some cases, oral corticosteroids or corticosteroid injections into the carpal tunnel may be considered if other methods to reduce inflammation are not successful.

Surgical treatment

Surgery is sometimes recommended when other treatment has not helped, if a carpal tunnel condition has continued for a long time, or if there is nerve damage or the risk of nerve damage. Surgery involves cutting the ligament that forms the roof of the carpal tunnel. This relieves the pressure on the median nerve, which eases or eliminates the symptoms of carpal tunnel syndrome.

See an illustration of the ligament involved in carpal tunnel release surgery.

Surgery is usually successful. In some cases it does not completely relieve the numbness and pain in the fingers or hand. This may be the case if there has been permanent nerve damage caused by long-standing carpal tunnel syndrome or by underlying conditions such as diabetes.

Should I have surgery for carpal tunnel syndrome?