Carpal Tunnel Treatment
Conveniently located to serve the areas of Beverly Hills and Los Angeles, CA
Our doctors are experts in the diagnosis and treatment of carpal tunnel syndrome for people throughout Los Angeles and Southern California. Whether you have just begun to experience symptoms or have been putting off treatment for a while, you have come to the right place. Our carpal tunnel specialists will help properly diagnose your condition and explain all your treatment options.
Carpal tunnel syndrome is a condition which affects the hands and wrists of many men and women in Los Angeles. The symptoms of carpal tunnel syndrome include pain and cramping of hands, numbness, and tingling of the fingers which may wake people at night and make them want to “shake-out their hands”. In more severe cases, carpal tunnel syndrome can also result in weakness of the hands to a point that people involuntarily drop objects. As carpal tunnel progresses it can also cause cramping and pain of the forearm, arms, and even the neck muscles.
Prevalence of carpal tunnel syndrome in the US is 7.8%, or one out of every 13 Americans (Scan J. of Work Envi, Sept. 2013). This incidence is even higher among working people, and has been reported to be up to 25% among people whose work involves extensive date entry. According to the New York Times, “every year more than 500,000 people in the US undergo surgeries for carpal tunnel syndrome”, with an associated cost in excess of $2 billion per year.
Our Hand Specialist often evaluate men and women who have developed carpal tunnel syndrome from extensive typing, texting, writing and other repetitive office activities. On the other hand, manual workers such as mechanics and laborers who use power tools can also develop Carpal Tunnel Syndrome.
Failure to properly treat carpal tunnel syndrome can cause permanent damage to function of your hands.
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What causes carpal tunnel syndrome?
The median nerve is the dominant nerve giving sensation to the thumb and index fingers, as well as strength to the thenar (thumb) muscles. The median nerve travels under a tight sheet in the forearm, which becomes the thick ligament roof of the carpal tunnel as it passes into the wrist. Thickening of the carpal ligament, inflammation and swelling of the flexor tendons, and structural narrowing of the carpal tunnel can all increase median nerve compression at the carpal tunnel, otherwise known as carpal tunnel syndrome. Specific causes of carpal tunnel syndrome include:
- Repetitive wrist movement, such as typing, twisting, and turning of the wrists.
- Natural thickening of the carpal ligament.
- Wrist fracture can cause a shift of the wrist bones, thus resulting in the narrowing of the carpal tunnel.
- Ganglion cysts in the wrist can put pressure on the median nerve.
- Inflammation and swelling of the wrists from pregnancy, weight gain, etc.
- Diabetes Mellitus. Gout, and other metabolic disorders can damage all nerves, including the median nerve.
Depending on how advanced your condition is, you may be eligible for treatment using non-surgical methods. For those cases where surgery is necessary, our doctors specialize in minimally invasive techniques. No matter what treatment you require, you can rest assured that you will be in good hands here at the Hand Surgery LA..
Carpal tunnel Syndrome Diagnosis:
There are several tests performed during a physical examination that can help to diagnose carpal tunnel syndrome, along with a reliable history of symptoms. Electrodiagnostic tests such as EMG/NCS as well as Ultrasound can help to confirm the diagnosis of carpal tunnel syndrome.
Treatment Options for Carpal Tunnel Syndrome:
Cases of mild carpal tunnel syndrome can be treated non-surgically with NSAID medication,, splinting, physical therapy, acupuncture, and a reduction in repetitive hand use. Mild to moderate cases of carpal tunnel syndrome can be treated with a steroid injection into the wrist, although the results may be temporary. Moderate to severe cases of carpal tunnel syndrome are most effectively treated with carpal tunnel surgery.
Drs. Sean Younai and Alex Neusner are fellowship trained hand surgeons who have successfully treated thousands of people who suffer from carpal tunnel syndrome. To schedule your consultation with Dr. Neusner or Younai you can schedule a consultation or call us at 818.386.1222. Doctors are available to see patients in Los Angeles, Encino, Glendale, and Bakersfield, We accept most insurances, and are providers for nearly all worker’s compensation MPN panels.
Frequently Asked Questions:
How can I prevent carpal tunnel syndrome?
There is no completely effective method of carpal tunnel syndrome prevention. However, avoiding repetitive hand motions and using ergonomic support to keep the wrist in a neutral position may be helpful. If you must type at work, using a wrist support and taking a 5 minute break every hour may help prevent tendon overuse and inflammation. If you start to notice nighttime hand tingling, wearing a wrist brace to avoid curling your hand will reduce pressure on the carpal tunnel. For most people, there is no single identifiable cause of carpal tunnel syndrome and it is largely unavoidable.
Does typing cause carpal tunnel syndrome?
Evidence is mixed regarding the association of typing with the development of carpal tunnel syndrome. However many studies have demonstrated increased pressure within the carpal tunnel during typing activity. A 2008 study by Rempel, et al. demonstrated that the posture of an extended wrist and ulnar deviation (towards the pinky finger) cause higher carpal tunnel pressure. Therefore, ergonomic supports that allow for a more neutral wrist position may be beneficial
Does texting cause carpal tunnel syndrome?
Prolonged smartphone use does seem to be correlated with a higher incidence of carpal tunnel syndrome. In particular, studies have shown that using a smartphone for over 3 hours per day corresponded to higher rates of hand pain and diagnosis of carpal tunnel syndrome.
Do I need to have surgery if I have carpal tunnel syndrome?
Not necessarily. There are different degrees of carpal tunnel syndrome. In early or mild disease where there is not much nerve compression, you may be a candidate for non operative management such as splinting, physical therapy, and activity modification. In some people, these treatments alone may provide lifelong relief. However, severe carpal tunnel syndrome may cause irreversible nerve damage. Therefore, it is important that you are evaluated by a carpal tunnel specialist such as the hand surgeons at Hand Surgery LA to determine the best therapy for your individual case.
Do I need general anesthesia for carpal tunnel surgery
Usually no. Most carpal tunnel surgery is performed with local anesthesia plus a light sedative. At Hand Surgery LA, you will always be monitored by a board certified anesthesiologist during your surgery.
Who treats carpal tunnel syndrome?
Although many different doctors may offer treatment for carpal tunnel syndrome, a fellowship trained hand specialist is the best option for managing your carpal tunnel syndrome. Hand surgeons like Dr. Neusner and Dr. Younai are highly experienced and trained in managing this condition and possess the most detailed understanding of hand and wrist anatomy and function.