Your Doctor Says It’s Carpal Tunnel Syndrome, Now What?

Hopefully you’ve been heeding my advice and you’ve gone to see your doctor about your hand pain. I’m going to guess that if he told you that he thinks you have carpal tunnel syndrome, he probably gave you a brace (or splint) and told you to come see him in a month. Hopefully he has referred you to a hand therapist or hand surgeon, and now you’re just waiting to see what happens next. Don’t panic. Once you understand what’s involved, I think you’ll feel a lot better.

So, let’s talk about that. What IS next?

First of all, let’s talk about what carpal tunnel syndrome really involves. Because if there is something that I’ve learned over the years, it’s that people don’t get a good explanation of what is really going on inside their hand. And as I always say, knowledge is power.

Your “carpal tunnel” is a space in the base of your palm that is formed by several wrist bones and a thick ligament. Imagine it like this: Make an “O” shape between your thumb and your index finger. Now, hold your arm in a way that forces your palm to be facing the ceiling. The bottom half of the circle is a group of bones. The top half of the circle is a ligament. You’ve just created a mock-up carpal tunnel.

Through that “tunnel”, you have several tendons (that make your fingers bend) and one very important nerve that operates your thumb muscles and also gives you sensation to your thumb, index, middle, and part of your ring finger. Over time, if those tendons swell, they will crush the nerve against the wall (which is the ligament we talked about earlier) and that pinches the nerve, forcing it to stop working well. Usually, your first symptom is numbness or tingling, then hand pain at night, and eventually you start dropping things because your thumb is getting weaker (and you can’t feel properly).

This information is good to have so that you understand WHY the doctor wants you to wear a splint. See, when you bend your wrist in either direction, you pinch the (already irritated) tunnel more, which cuts off the nerve supply and makes your symptoms worse. The purpose of the splint is to keep your wrist “straight” so that the tunnel is as open as possible. Sometimes a splint is all you need to completely recover. Problem solved!

Go ahead and make that “O” again with your thumb and index finger. Now leave a slight gap where your fingers should be touching. When a surgeon performs a carpal tunnel release, he is simply cutting that ligament in half so that it relieves the pressure that has been squishing the nerve. He doesn’t remove anything. He just opens up the space so that your nerve can “breathe” again. Easy peasy! You will usually have to take it easy for a few weeks, and maybe spend another few in therapy, but after that, you are as good as new!

See? That’s not so bad.