Conditions

Entrapment Neuropathies

What is carpal tunnel syndrome?

Carpal tunnel syndrome arises when your median nerve becomes constricted as it passes through your hand. Carpal tunnel syndrome causes weakness and a pins and needles sensation on one side of your hand near your thumb.

What are some of the reasons for carpal tunnel syndrome?

Pain as a result of carpal tunnel syndrome occurs when there’s an increase of pressure within your wrist, particularly on your median nerve. People who have diabetes, thyroid dysfunction, high blood pressure or wrist fractures are at risk of carpal tunnel syndrome.

What are the signs of carpal tunnel syndrome?

If you have carpal tunnel syndrome, you will frequently drop items, and your hand may “fall asleep” at certain times. Other signs of this condition include:

  • Pain and a tingling sensation in your thumb
  • Pain that travels through your arm
  • Weak hand muscles
  • Wrist pain in the evening

How is carpal tunnel syndrome treated?

Dr Botha conducts a physical exam as well as a nerve pressure test to assess the strength of your hand muscles and diagnose carpal tunnel syndrome. She will decide if she can manage you conservatively or if you need surgery according to the clinical findings.  She might also send you for a nerve conduction study if needed.

Once the doctor confirms your diagnosis, she will recommend treatments that include:

  • Conservative (Splinting and medication): The doctor prescribes pain medication to alleviate inflammation.
  • Surgery: If your median nerve is severely damaged, Dr Botha will recommend surgery to reduce pressure on your nerve.

What is cubital tunnel syndrome?

Because of cubital tunnel syndrome, your ulnar nerve, also referred to as your “funny bone” nerve, becomes stretched and this causes numbness in your small fingers as well as your ring finger.

What are some of the causes of cubital tunnel syndrome?

Pressure is one of the causes of cubital tunnel syndrome. Although your ulnar nerve has some padding over it, when you lean your arm against an object, this can press your nerve. Because of this direct pressure, your arm and hand, particularly your ring and other fingers become numb and “fall asleep”.

Stretching is another cause of cubital tunnel syndrome. When you bend your elbow for a long time, you can pull the nerve behind your elbow. Not only is cubital tunnel syndrome triggered by pressure or stretching, but sometimes, it's merely your anatomy that could be the cause of the condition. For some people, the ulnar nerve doesn't remain in its fixed position. The nerve instead continually snaps in and out of its position as the elbow moves. This continuous snapping can irritate your nerve.

How do I know I have cubital tunnel syndrome?

Signs of cubital tunnel syndrome include:

  • Pain
  • Loss of sensation in your fingers, particularly your ring fingers
  • Weakness in your fingers

How is cubital tunnel syndrome treated?

After the doctor confirms your diagnosis, management will be determined on how severe it is.  Management consists of conservative treatment (NSAIDs, occupational or physiotherapist) and surgery.  For some severe cases, the doctor performs surgery to treat pain or a numb sensation in your fingers from cubital tunnel syndrome.

During surgery, Dr Botha releases your nerve. Although surgery remains an option, the doctor will first discuss conservative treatment options before she performs surgery to alleviate pressure on your nerve.

1Can nerve conduction studies be used to diagnose carpal tunnel syndrome?
A physical exam and nerve conduction test are ways to diagnose carpal tunnel syndrome. A nerve conduction test measures the impulse speed of your nerves. When the nerve travels at a slow speed through the hand, this is often a sign of carpal tunnel syndrome. We can also send you for a sonar, but it is, in general, a clinical diagnosis.
2Is cubital tunnel syndrome a permanent condition?
Cubital tunnel syndrome can result in irreversible nerve damage in the hand when not treated early enough. Often, when conservative remedies are ineffective in relieving pain and numbness in the hand, Dr Botha performs surgery by releasing the trapped nerve.
3What are the conservative treatments for carpal tunnel syndrome and cubital tunnel syndrome?
Non-surgical treatments for carpal tunnel syndrome and cubital tunnel syndrome include splinting, steroid injections, non-steroidal anti-inflammatories, modified exercises and hand therapy.
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