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<h1 style="text-align: left;">&nbsp;</h1>
<h1 style="text-align: left;">Hand Pain, Numbness, Weakness from Carpal Tunnel Syndrome Can Be Treated with Endoscopic Surgery </h1>
In daily life, when we need to use our hands repetitively for a long time or use them too strenuously, it may cause hand pain, numbness, weakness, and frequent dropping of objects. These symptoms may be caused by carpal tunnel syndrome (CTS), which is the compression of the median nerve at the wrist. If left untreated, the symptoms will worsen and can eventually lead to muscle atrophy in the hand.
This article discusses carpal tunnel syndrome to help understand its causes, treatment, and wrist care. Importantly, if you experience pain, numbness, or weakness in the wrist, you should promptly consult a doctor for timely diagnosis and treatment.
Table of Contents&nbsp;
<ol style="text-align: left;">
<li style="" aria-level="1">What Causes Carpal Tunnel Syndrome?</li>
<li style="" aria-level="1">Risk Factors for Carpal Tunnel Syndrome&nbsp;</li>
<li style="" aria-level="1">What Are the Symptoms of Carpal Tunnel Syndrome?</li>
<li style="" aria-level="1">How to Know if You Have Carpal Tunnel Syndrome&nbsp;</li>
<li style="" aria-level="1">How to Treat Carpal Tunnel Syndrome?</li>
<li style="" aria-level="1">Prevention of Carpal Tunnel Syndrome</li>
</ol>
What Causes Carpal Tunnel Syndrome? At the wrist, there is a tunnel through which tendons and nerves pass from the forearm to the palm. The structure of the carpal tunnel consists of wrist bones at the bottom and a ligament at the top. Repetitive or heavy use of the hands over a long period can cause injury to the tissues inside the carpal tunnel, leading to inflammation and swelling.
This condition causes compression of the nerve, resulting in reduced blood supply to the nerve in the hand, causing pain and numbness in the palm. If untreated, the hand will become weak, leading to paralysis. Muscle atrophy can be seen in the thenar eminence (the fleshy area at the base of the thumb).
<h2 style="text-align: left;">Risk Factors for Carpal Tunnel Syndrome</h2>
<ul style="text-align: left;">
<li>Repetitive or heavy use of the hands and wrists</li>
<li>Congenital abnormal narrow carpal tunnel</li>
<li>Wrist injuries</li>
<li>Pregnancy</li>
<li>Menopause</li>
<li>Use of contraceptive pills</li>
<li>Diabetes</li>
<li>Rheumatoid arthritis</li>
<li>Obesity</li>
<li>Gout</li>
<li>Presence of tumors or cysts in the wrist area</li>
</ul>
What Are the Symptoms of Carpal Tunnel Syndrome? Initially, there will be numbness in the fingertips, which may affect one or several fingers. The numbness gradually worsens and is accompanied by pain, especially at night. Sometimes the pain is severe enough to wake the patient, who then shakes the hand to relieve it before going back to sleep.
Later, the pain may become so severe that it prevents sleep. The pain is worst when the wrist is bent. If untreated, the hand will weaken, objects will frequently slip from the hand, the thenar muscles will begin to atrophy, and the hand may become paralyzed with finger deformities.
If treatment is delayed, the symptoms may become permanent, including numbness, weakness, muscle atrophy, and finger deformities. Patients who notice these symptoms interfering with daily life should promptly see a doctor for treatment.
How to Know if You Have Carpal Tunnel Syndrome? Diagnosis of carpal tunnel syndrome involves medical history and physical examination. The doctor will test the muscles of the palm and each finger, tap lightly over the nerve, bend the wrist, or press on the nerve to provoke symptoms. Blood tests may be done to check for related diseases, and wrist X-rays to detect structural abnormalities of the carpal tunnel. Electromyography (EMG) and nerve conduction studies are used to confirm the diagnosis.
However, in some patients, EMG and nerve conduction studies may be normal even if carpal tunnel syndrome is present, so these tests should be used alongside other diagnostic methods.
How to Treat Carpal Tunnel Syndrome? Treatment depends on the severity and duration of the condition and includes the following methods:
<ul style="text-align: left;">
<li style="text-align: justify;">Resting the hand Helps reduce inflammation and swelling, which decreases nerve compression and improves blood flow to the nerve, aiding recovery. Afterwards, hand use habits should be adjusted appropriately.</li>
<li style="text-align: justify;">Nonsteroidal anti-inflammatory drugs (NSAIDs) Help reduce inflammation and swelling, which may improve symptoms in mild cases. However, they should not be used long-term due to potential side effects such as stomach ulcers and kidney disease.</li>
<li style="text-align: justify;">Vitamin B Helps nerve recovery and is effective in mild cases. Should be used in combination with other treatments.</li>
<li style="text-align: justify;">Use of wrist splints Helps reduce pressure inside the carpal tunnel, improving blood flow to the nerve. Recommended to wear during sleep.</li>
<li style="text-align: justify;">Corticosteroid injection into the carpal tunnel Used when other treatments fail. The injection reduces inflammation inside the carpal tunnel but should not be given more than twice to avoid chronic inflammation from nerve irritation.</li>
<li style="text-align: justify;">Carpal tunnel ligament release surgery This is the last resort treatment for carpal tunnel syndrome. It permanently enlarges the carpal tunnel by cutting the ligament. The procedure is done under local anesthesia without hospital admission. The incision is usually 3-4 cm long at the base of the palm. Stitches can be removed after 7-10 days, and normal hand use can resume thereafter.</li>
<li style="text-align: justify;">Endoscopic carpal tunnel release surgery The ligament is cut using an endoscope through a small incision about 1 cm long at the wrist, parallel to the wrist crease to hide the scar. This procedure takes about 20 minutes under local anesthesia without hospital admission. Advantages include less scarring, less postoperative pain, quicker recovery, and better long-term cosmetic results compared to traditional surgery.</li>
</ul>
Prevention of Carpal Tunnel Syndrome There is no direct way to prevent carpal tunnel syndrome because causes such as genetics or congenital abnormalities cannot be changed. However, the risk can be reduced by avoiding heavy or repetitive use of the hands and wrists. Recommendations include:
<ul style="text-align: left;">
<li>Avoid heavy use of hands and wrists. When working with a mouse and computer, maintain proper hand posture. Place the keyboard at or slightly below elbow level and avoid extreme wrist bending up or down.</li>
<li>Take regular breaks during work to stretch, bend, and rotate the hands and wrists.</li>
<li>Do not sleep on your hands. If wearing wrist supports, ensure they are not too tight during sleep.</li>
<li>In cold weather, wear gloves to keep hands warm, which helps reduce stiffness and pain.</li>
<li>Treat underlying conditions that cause nerve compression, such as diabetes, rheumatoid arthritis, obesity, and gout.</li>
</ul>
Carpal tunnel syndrome can affect anyone, especially in today’s world where many people use their wrists heavily and repetitively every day. Therefore, if you experience hand pain, numbness, or weakness that affects daily life, observe your symptoms and see a doctor promptly for treatment before the condition worsens. Also, adjust your habits to reduce the risk of recurrence to keep your wrists strong and functional in the long term.
Assoc. Prof. Dr. Adisak Sangpetch Hand Surgeon, Muscle, Bone, and Joint Center Phyathai 3 Hospital, 1st Floor For more information, contact Phyathai Call Center 1772 Tel. 0-2467-1111 ext. 3100 and 3112
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Hand pain, numbness, and weakness. Using the wrist heavily may cause carpal tunnel syndrome. Get to know the symptoms, causes, dangers, and proper care and treatment.

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