Episode Transcript
Dr. Miller: What is carpal tunnel syndrome? We're going to talk about that next on Scope Radio.
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Dr. Miller: Hi, I'm Dr. Tom Miller and I'm here with Dr. Doug Hutchinson. He's a Professor of Orthopedic Surgery here at the University of Utah. Doug, what is carpal tunnel syndrome? What is that?
Dr. Hutchinson: Tom, carpal tunnel syndrome is a common diagnosis, and frankly, it's commonly missed diagnosed in the lay public. Carpal tunnel syndrome primarily is numbness in your fingers. Carpal tunnel syndrome is not primarily wrist pain. That's the first misconception I'd like to solve. So if you have wrist pain, it's a different story. If you primarily have numbness, sometimes it comes with pain, but mostly it's numbness.
Dr. Miller: What causes that numbness?
Dr. Hutchinson: What's happening is the median nerve, with is a main nerve that goes into your hand through your wrist, goes through a tight tunnel where all the tendons for your fingers are also located, and basically our assumption is that the space is so limited that if you use your tendons a lot, which we all do over the course of years, there will be a little bit of a buildup of tissue in there, and maybe a little bit of inflammation, though it's not much, but enough to make it so that the nerve feels claustrophobic, if you will, and pressured. Therefore, pressure on a nerve creates numbness where that nerve is going or coming from, and in this case that nerve is coming from those fingers.
So carpal tunnel syndrome is numbness in most of your fingers. Sometimes they feel as though it's all their fingers. Usually it's the thumb, index and third finger primarily. It usually comes at night because of the way we sleep on our wrists, and that is part of the treatment right there, is to change the way we sleep with our wrists bent.
Dr. Miller: Now, are some people at greater risk of developing carpal tunnel than others?
Dr. Hutchinson: The common person who has carpal tunnel is 40s, 50s, 60s, and a little bit more often in a female than in a male. There's a lot of history of whether these come from repetitive activities and computers, and probably the bias and my answer is it doesn't. It's primarily genetic. It's primarily something that you were going to get anyhow even if you lived in rubber room your entire life and didn't do anything with your hands. It's just something that eventually can happen to some people because the nerve's in a tight spot in the wrist, and certain movements and certain positions will make that nerve a little bit unhappy over time and it will want a little bit of a bigger house.
Dr. Miller: Does it usually occur in the dominant hand or in both hands?
Dr. Hutchinson: Usually it's in the dominant hand first, but it usually occurs in both hands eventually.
Dr. Miller: Now, I heard that it's more common in pregnant women. Is that true?
Dr. Hutchinson: Pregnant women are very common, and anybody else who has major fluid changes, etc., and even can come in some women around their periods because of that type of change. Post-menopausal women are clearly the most common when it comes in. So yeah, there are changes that can occur. Some people will have something like a ganglion cyst that will actually put pressure in that area, and that can cause carpal tunnel syndrome. But usually it's idiopathic, and that means that there's no real cause for it, it just is happening to them.
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