John "Jack" McCarthy, M.D ., Orthopaedic surgeon with the Alegent Health Orthopaedic Institute Find out more about Dr. McCarthy At the base of the palm is a canal or "tunnel" which tendons and nerves pass on their way from the forearm to the hand and fingers. This narrow passage between the forearm and hand is called the "The Carpal Tunnel." If you have tingling, numbness or an ache in your wrist or hand, especially during the night, you may have carpal tunnel syndrome, a common condition that is the result of too much pressure on the median nerve within the carpal tunnel of the wrist.

"No one knows what causes carpal tunnel syndrome," says Dr. John "Jack" McCarthy, orthopaedic surgeon with the Alegent Health Orthopaedic Institute, "but there are several predisposing factors."

"For example," says Dr. McCarthy, "carpal tunnel syndrome generally affects people over 45, especially women. Metabolic conditions (such as diabetes and hypothyroidism), pregnancy and inflammatory diseases can contribute to carpal tunnel syndrome as well as some occupations. "

Occupations that require both repetitive use of the hands such as writing, typing and data entry and other occupations that require excessive force of the hands, such as meatpacking, carpentry or construction put people at risk for developing carpal tunnel syndrome.

Early treatment consists of a combination of splinting, anti-inflammatory medications, exercises and activity modifications. In some cases, surgery may eventually be required.

Carpal tunnel surgery, done on an outpatient basis, is one of the most common procedures performed by orthopaedic surgeons. It consists of releasing the transverse carpal ligament in the wrist to take pressure off the nerve.

The surgery is performed either through an open incision in the palm of the hand or with a small device called an endoscope which is inserted through an incision at the wrist crease. Recuperation can take several days to weeks depending on the person's occupation.