Cortisone injection for carpal tunnel
Cortisone injection for carpal tunnel

Carpal Tunnel Diagnosis and Treatment

An article published in 2020 had suggested that around 4-5% of people around the world suffer from carpal tunnel syndrome. Those who are between the ages of forty to sixty years are likely to suffer from this . However, the percentage of women is greater than men. Out of a total number of 100000, 193 women compared to 88 men are often seen to be diagnosed. UK has recorded 7-16% of people having carpal tunnel syndrome.

Carpal tunnel syndrome is a serious condition. Without medical intervention, it can result in severe pain and loss of movement. One option for treatment would be cortisone injections for carpal tunnel syndrome.

What is the Carpal Tunnel?

It is a narrow, bony passage in our hands, surrounded by ligaments. It provides passage to the median nerve that starts in the upper arm and provides sensation to our fingers (apart from the little finger).

Understanding the Syndrome

This is a painful progressive condition. As the median nerve gets compressed due to excessive pressure inside the carpal tunnel, the individual starts feeling a sense of tingling and numbness in the hand. The pain can radiate up the arm. The situation may need urgent medical attention to relieve the pressure upon the nerve and relief the symptoms.

It goes without saying that symptoms will spiral out of control if left untreated. It might cause:

  • Nerve damage
  • Muscle weakness
  • Chronic pain

As part of the initial treatment, one can wear a splint and perform light exercises. Cortisone injections can help you deal with the associated pain and inflammation, if conservative management is not helping.

Who is at Risk?

It is common in:

  • Women, especially pregnant women
  • People with medical conditions
    •  Osteoarthritis
    • Rheumatoid arthritis
    • Hypothyroidism
    • Gout
    •  Diabetes
    • Obesity
  • Those with a family history of carpal tunnel syndrome

If you suspect having carpal tunnel, an early doctor’s visit might save you a lot of pain. Simple management routes like exercise and cortisone injection for carpal tunnel are effective at an early stage.

What are the Causes of Carpal Tunnel Syndrome ?

The following are potential reasons for this condition:

  • Chronically bent wrist positioning
  • Repetitive hand motions
  • Inflammation like arthritis
  • Swelling due to hormonal changes
  • Fluid retention
  • Nerve damage
  • Chronic illness
  • Severe sprains
  • Fractures

Common Symptoms that You Will Experience

Note if you suffering from any of the following:

  • Fingers, especially your thumb, index, and middle finger, has
    • Tingling
    • Numbness and loss of sensation
    • Burning
    • Pain
    • Weakness
    • Shock-like feeling
  • Weakness and trouble getting a proper grip
  • Pain traveling up your arms to your shoulders
  • Cold, swollen fingers
  • Having clumsy finger movements
  • Loss of muscle at the base of your thumb

If you notice the above symptoms, perform a few tests at home to see if you potentially have carpal tunnel syndrome.

At Home Tests You Can Try

Before you go to the doctor, try out some simple checks at home to see whether it is carpal tunnel syndrome. 

  • Tinel’s Sign

Tap your median nerve. Do you feel the pain shoot up your hand?

  • Phalen’s Test

Flex your wrist and hold the backs of your hands together for a minute. Do your fingers tingle?

  • Flick Test

Shake your wrist like you would when adjusting a thermometer. Does the movement ease your symptoms?

It is advisable to get medical attention right away if you check positive for any of the above. You can expect accurate diagnosis only if you go through detailed physical examination and imaging.

Diagnostic Techniques of CTS:

Doctors usually perform the following to reach a diagnosis:

  • Physical examination
  • Electromyography to evaluate the extent of nerve damage
  • Nerve conduction study
  • MRI to detect ligament damage
  • Ultrasonography to rule out other issues
  • Other tests
    • Tinel’s sign
    • Phalen’s test
    • Carpal Compression Test

How is CTS treated?

Your doctor will determine your treatment plan after a thorough evaluation of the following:

  • severity of the symptoms
  • pain level
  • your age
  • physical health
  • pre-existing medical conditions
  • your preference
Non-Surgical Methods

Patients and doctors always prefer non-invasive procedures.

For carpal tunnel syndrome, treatments include:

  • Using a splint
  • Avoid repetitive wrist motions
  • Exercise or physical therapy
  • Ergonomic changes in your daily life

Using cortisone injection for carpal tunnel, when combined with exercise, usually gives good results at an early stage.

Surgical Methods

If left untreated for too long, the mobility loss and pain from carpal tunnel syndrome will become too much to deal with. Doctors suggest surgical intervention in severe cases.

The three most common options are:

  • Carpal Tunnel Release Surgery

It is done as a permanent solution to make your carpal tunnel bigger.

  • Open Release

It helps relieve pressure

  • Endoscopic Release

It involves making two small cuts and using a guide camera. It has less recovery time.

Damage to your carpal tunnel can be irreversible. Seek early medical intervention.

Pain Management

CTS can cause extreme pain that hampers quality of life. To manage this, we recommend the following:

  • Use a splint at night
  • Take painkillers that can be bought over the counter
  • Resort to non-steroidal and anti-inflammatory drugs
  • Opt for ultrasound-guided cortisone injections

Is Cortisone Injection for Carpal Tunnel Effective?

Ultrasound-guided injections for carpal tunnel are a good way of managing the pain. In fact, they are effective in about 80% of cases.

Conclusion

CTS is indeed a painful condition but is manageable. A well-planned physiotherapy regimen and if needed, an ultrasound-guided cortisone injections is the usual combination for treating this conditions and restoring quality of life. Surgery is used in resistant cases.

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