Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy, impacting between 3% and 6% of the U.S. adult population and making up an estimated 90% of all neuropathies. When this painful and debilitating condition becomes acute, it requires surgery to alleviate the pain, prevent permanent damage, and improve mobility. If you have a carpal tunnel syndrome diagnosis, you may have concerns about the procedure and recovery time, including how much time off work you may need and whether workers’ compensation in New York covers CTS.
In your wrist, you have a group of bones called carpal bones. The transverse carpal ligament binds these bones together tightly, leaving just a 1-inch opening. Flexor tendons and the median nerve pass through the carpal tunnel. The median nerve begins in the neck as a nerve bundle that combines into a single nerve in the arm before traveling down the arm to the fingers.
The flexor tendons permit you to move your fingers and thumb, while the median nerve controls muscle movements in the hand, wrist and forearm. This nerve also conveys sensory information from the hand and lower arm to the brain. The synovium encases the flexor tendons, lubricating them to improve movement. If the synovium swells, it compresses the median nerve, causing inflammation and leading to carpal tunnel. Often, people can take measures to alleviate symptoms in the early stages, but if the condition persists, they may need carpal tunnel release surgery.
This condition arises slowly and progresses over time unless the individual takes steps to reverse symptoms early. However, people often find it challenging to stop the types of movement that cause them to develop carpal tunnel syndrome in the first place. It’s important to diagnose carpal tunnel syndrome early to prevent symptoms from worsening. Symptoms may include:
When people first experience indications, they often don’t persist. They may arise during specific activities and then go away. As the condition progresses, the symptoms worsen and last longer. People also frequently experience an increase in symptoms at night because they sleep with their wrists in a flexed position, which puts additional pressure on the median nerve.
Carpal tunnel has many potential causes and risk factors, and it is often hard to determine a single factor that led to the condition. Even though you may often hear people referring to it as a repetitive use condition, anything that leads to median nerve compression or swelling may contribute to carpal tunnel development.
Older people are more likely to develop severe carpal tunnel. There are two age group peaks for developing carpal tunnel. Middle-aged adults aged 50-54 and elderly adults aged 75-84 are more likely to have carpal tunnel than other age groups. Elderly adults have more severe cases and demonstrate higher rates of thenar muscle (the muscles that move the thumb) atrophy. Carpal tunnel release surgery is a viable option for people with CTS in any age group.
Anyone can develop CTS, but women have a higher chance of getting it than men, especially between the ages of 45 and 54. Their risk is three times greater, but scientists don’t know exactly why. One potential reason is the hormonal changes women undergo during pregnancy and menopause. Another possible factor that increases the risk for women is that their wrists are usually structurally smaller than men’s wrists, creating a smaller carpal tunnels for the median nerve and flexor tendons to pass through.
Your genes play a significant role in your body’s anatomical structure. If your family has a more petite skeletal frame, making your wrist smaller, heredity may be a contributing factor to your carpal tunnel. In addition to size, you may have other morphological features that reduce the amount of space in the carpal tunnel. Carpal tunnel surgery is often beneficial for those whose genetics contribute to their carpal tunnel syndrome.
Genetic factors aren’t the only causes for changes in people’s anatomical structure. A broken or dislocated wrist can alter the wrist bones, reducing the size or changing the shape of the carpal tunnel. A bone spur on a wrist bone may also lead to a crowded space that increases the risk of CST.
People who have a high body mass index are more likely to develop CTS. One potential reason for the increased risk may be that significantly overweight people often have fluid buildup in their joints. As with many other contributing factors, this excess fluid increases the pressure on the median nerve.
Inflammation causes swelling, so it may lead to carpal tunnel if the inflammation occurs in the wrist. Specific health conditions — such as rheumatoid arthritis — target the joints and cause inflammation in these areas. Other autoimmune diseases cause systemic inflammation that increases the potential for carpal tunnel. However, any type of inflammatory condition that causes swelling in the soft tissues surrounding the flexor tendons may contribute to or increase the risk of CTS.
In addition to diabetes and inflammatory conditions, other medical conditions may increase the risk of developing carpal tunnel. Examples of these diseases include diabetes, hypothyroidism, and end-stage renal failure. In some instances, carpal tunnel release surgery may ease the symptoms, especially if the underlying medical condition is chronic.
If your body retains excess fluid, the fluid may accumulate in the joints and increase the risk for CTS. In some instances, taking specific steps to reduce retention may improve your condition. Fluid retention is common for pregnant women and women going through menopause. Pregnancy-induced carpal tunnel syndrome often goes away on its own after giving birth.
While many attribute repetitive motion activities to work-related tasks, this category is broader than the activities people engage in at work. Any type of activity that people do on a regular basis that leads to repetition in hand and wrist movement or consistent gripping with the hand may contribute to CST and require carpal tunnel surgery.
Repetitive movement may cause flexor tendon irritation and swelling or thickening of the synovium, leading to increased pressure on the median nerve in the carpal tunnel. Examples of non-work-related repetitive motion activities include:
Your occupation may be a contributing factor in your CTS. As with any other factor, it is often difficult to pin down a direct cause. However, CTS does appear more prevalent in some jobs than in others. A national health interview survey found that of the 6.7% of respondents who had clinically diagnosed CST, clinicians in 67% of the cases attributed the condition to the patient’s work.
According to a Centers for Disease Control (CDC) report, the association between occupation and carpal tunnel is higher for those who:
Interestingly, one study demonstrated that carpal tunnel is more prevalent in occupations that do not require significant computer usage than those that do. When CST is work-related, workers’ compensation may cover carpal tunnel surgery. However, demonstrating that your job caused your carpal tunnel can be challenging. Additionally, in places like New York, workers’ compensation boards may have specific guidelines for you to follow before you can consider undergoing surgery if you want it covered under workers’ compensation. At Accident Help Zone, we provide resources for anyone who needs information about workers’ comp in New York.
Carpal tunnel is painful and debilitating, and it’s important to address the issue before you sustain permanent damage. Your options, including carpal tunnel release surgery, depend in part on how severe your condition is, what you’ve tried so far and whether you plan to file a workers’ compensation claim. Diagnosing carpal tunnel syndrome is an important part of this process.
Your first option is always to do nothing. Unfortunately, carpal tunnel syndrome doesn’t typically go away if you don’t take any steps to reduce the inflammation. Instead, the condition worsens over time. Without treatment, you may end up with permanent nerve damage that surgery can’t resolve.
If your CST is in the early stages, your doctor may recommend non-surgical options, including:
However, your symptoms are likely to return without subsequent changes to your environment or activities.
Surgeons perform an estimated 400,000 surgeries for carpal tunnel every year. If your injury is work-related, your state may require you to try all non-surgical options before the workers’ comp board approves a claim for surgery. A CST surgeon performs the surgery in one of two ways.
Both types are out-patient procedures, so you are in and out in a short time. They both also accomplish the same outcome: They open the carpal tunnel to alleviate the pressure on the median nerve.
Initially, open release surgery was the only option available. In this procedure, doctors anesthetize the hand and wrist before performing the surgery. They then make an incision on the wrist, running from the palm down to the bottom of the wrist. The incision exposes the transverse ligaments that cross over the median nerve and flexor tendons.
Next, surgeons carefully slice across the ligaments, separating them into two parts and, consequently, enlarging the carpal tunnel. Doing so alleviates the pressure on the median nerve. The ligaments may eventually grow back together, but there will still be extra room in the carpal tunnel.
The procedure for endoscopic release surgery is similar to open release surgery. The primary difference is in how the surgeon makes the incision and cuts the ligaments. When workers’ compensation doctors perform endoscopic surgery to treat carpal tunnel syndrome, they make a small incision and insert a tiny camera through the portal. They then manipulate the camera under the band of ligaments and use a knife attached to the camera to make the slice.
Though the risks of surgery for CST are few, you should still know what they are. For some people, anesthesia is a problem, but this happens most often when a person is under general anesthesia. Other potential risks include:
Contact your doctor if you develop a fever, experience itching, draining or swelling at the incision site, or have an increase in pain. These may be signs of an infection.
Many people who need surgery worry about how much time it takes to recover and when they can return to work. There is no straightforward answer to these questions. Every person’s situation is different, so recovery times vary and can range from a few days to several months for complete recovery from carpal tunnel release surgery.
After surgery, you will likely wear a splint or heavy bandage for up to two weeks. Your doctor will probably require you to come into the office for removal. Your doctor may also order physical therapy to speed up the healing process and improve wrist and hand functioning. You may also need to elevate your hand at different times during the day and overnight to reduce the swelling.
Immediately after surgery, your doctor will likely talk to you about the activities that are safe for you to perform. Often, people can use their hands shortly after carpal tunnel surgery for activities such as driving, light lifting, and self-care. Your doctor may restrict other activities to ensure your wrist heals completely from carpal tunnel syndrome surgery. These restrictions may impact your work.
Getting back to work is a significant factor for those deciding whether to pursue surgery for CTS. You may need to take a few days off work on the day off and immediately follow the procedure. However, many people can return to their jobs in some capacity before they fully recover. It often takes about a week before people can write for short periods of time, but it can take up to six weeks before you can perform tasks that require pinching, gripping, or pulling.
Before your surgery, you can discuss your options with your doctor and employer. Your physician may release you to go back to work before you fully recover, as long as you can perform light-duty activities. It may be helpful to determine potential alternatives for work tasks before you get the procedure done.
At Accident Help Zone, our goal is to help people get the information and support they need when they have a workplace or auto accident. If you have carpal tunnel syndrome, you have the right to understand how the condition impacts your life and work. Doctors listed in our directory accept workers’ compensation, no-fault, and most insurance plans. Peruse our site, and if you have any questions, please feel free to get in touch or call (888) 412-8488 to schedule an appointment today!
If you or your family member have been involved in an auto accident, injured at work, or suffered a slip & fall accident in New York or New Jersey, we invite you to explore our free comprehensive library.
Whether you need more information about filing your workers’ compensation claim or need to find an experienced doctor or personal injury lawyer, you’ve come to the right place – Accident Help Zone is here to help you and your loved ones!
The content on this site is for informational purposes and should not be considered as legal advice, medical diagnosis or treatment recommendations for your accident injuries.
Worker’s Comp & Car Accident Help Zone Copyright ©