Britt Talley Daniel MD literary website

Britt Talley Daniel MD is a retired neurologist and headache doctor.

The Mini Neurology Series: Volume 2: Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a leading cause of health and fitness disability and is found in 10% of Americans. It is a common disease of the peripheral nervous system and a median nerve entrapment wherein the main sensory nerve to the hand, the Median Nerve, is compressed and irritated at the wrist. CTS is found in women three times more often than in men. Many persons who get this medical neurology problem have a smaller carpal tunnel than normal and this anatomic constriction leads to symptoms. Common initial symptoms are numbness, “pins and needles”, tingling, a dead sensation, and a lack of feeling which is usually in the fingers and hand. Later there may be weakness of the hand, swelling, and atrophy, or wasting of the base of the thumb. Work up includes a neurologic exam and sometimes a cervical MRI scan to rule out a herniated disc. The gold standard test is electromyography which consists of two parts: nerve conduction studies, and insertion of a small needle in the arm and hand muscles, called the needle exam. Treatment options are rest of the hand, neutral splinting at night and during the day, 1 or 2 cortisone injections separated by a month or so, and for some patients—surgery, which is usually successful. Following up with brevity and wit the great success of Volume 1 of the new Mini Neurology Series, on migraine, Volume 2 on Carpal Tunnel Syndrome is not too short and not too long; it’s just right and reviews the key medical features and therapy—pregnancy, surgery, electromyography, and ultrasound—of the weak, the swollen hands of the world…from carpal tunnel syndrome.