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Carpal Tunnel Syndrome Provider Treatments

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How and when to see a provider

You should see a healthcare provider if your carpal tunnel syndrome symptoms like finger numbness, wrist pain, and hand weakness are not getting better after about 2 weeks of home treatments.

Carpal tunnel syndrome should be treated as soon as possible because pressure on the nerve over time can lead to permanent muscle loss, chronic symptoms, and may make surgery (if needed) less successful.

Carpal tunnel syndrome symptoms can mimic more serious conditions like pinched nerves in the neck or certain neurological conditions. So it’s important to see a healthcare provider if you’re not sure you have carpal tunnel syndrome.

Go to the ER if any of these symptoms are severe: pain and swelling, numbness and tingling in the fingers, and weakness of the fingers (especially after a fall or other trauma to the hand and wrist).

Getting diagnosed for carpal tunnel syndrome

Many people with carpal tunnel syndrome symptoms can be treated without getting a definite diagnosis. But if treatments aren’t helping, your doctor may recommend seeing a hand/upper and extremity specialist.

  • The doctor may use special tools to test the sensation in your fingers.
  • In some cases, a nerve test called an electromyogram (EMG) may be necessary if the cause of your symptoms is not clear. This test can help figure out if your pain and numbness/tingling are from nerve pressure in your wrist or from a different location such as your neck.

What to expect from your visit

Your visit will start with a thorough history and physical exam. The doctor will discuss your current treatments and any OTC medications you’re taking.

  • They may recommend prescription-strength NSAID medications to reduce pain and swelling in your wrist and hand.
  • In some cases, your doctor may do a cortisone injection. After numbing the skin, a small needle is used to inject cortisone into the wrist. You should feel relief within a few days and the treatment lasts on average 4–6 weeks.
  • You may be given a splint to wear at night.
  • Your doctor may recommend physical therapy or special hand therapy. Therapy may include exercises to stretch the wrist, ultrasound treatments, hot wax treatment, and iontophoresis (electrical current).
  • If your carpal tunnel was caused by repetitive movements, you may be referred to an occupational therapist.

What are the treatments for severe carpal tunnel?

Surgery may be needed if other treatments don’t help your symptoms.

The most common procedure is a carpal tunnel release (CTR). The surgeon will cut the tissue in the underside of your wrist that puts pressure on the median nerve. This surgery may be done through a regular incision or through tiny incisions using special instruments (endoscopic carpal tunnel release).

Symptoms will gradually go away as it heals. Depending on what you do for a living, you can expect to resume everyday job duties in 1–6 weeks. You can expect pinch strength to return within 6 weeks and grip strength in 3 months.

Prescription NSAID medications

  • Meloxicam (Mobic)
  • Nabumetone (Relafen)
  • Naproxen (Naprosyn)
  • Ibuprofen (Motrin)
  • Celecoxib (Celebrex)
  • Etodolac (Lodine)

Types of carpal tunnel syndrome providers

  • A primary care physician or other general healthcare provider can treat mild to moderate symptoms.
  • An upper extremity or hand specialist may be required for more advanced symptoms or symptoms that don’t respond to an initial course of treatment. These specialists are orthopedic surgeons or plastic surgeons who have had additional training to treat disorders of the hand, wrist, and elbow.
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