What’s that buzzing feeling in my hand?

What’s that buzzing feeling in my hand?

So what is that buzzing in my fingers?

Have you ever felt like your hand is completely asleep and you have to shake it loose to try to wake it up. Does it happen when you’re talking on the phone or when you’re writing a letter or signing a check. Does the hand sometimes feel hot or cold?  Do you have pain that goes from your wrist all the way up your arm and to your neck. Do your hands wake you up in the middle of the night with this buzzing sensation that just won’t go away? You might have carpal tunnel.

So what the heck is carpal tunnel anyhow?

Your carpal tunnel is an area on your wrist on the palm side. It is an anatomic structure that is formed by bones on the floor of the tunnel and a thick band of tissue called a ligament on the roof of the tunnel. Within the tunnel live nine tendons and an important structure called the median nerve. Tendons are necessary to move our fingers and to grasp objects and to perform complex tasks like writing. The median nerve is essentially a fiber optic wire that carries signals from our fingertips up to our brains. It also has fibers that supply muscles in the hand with electricity so that they can perform important functions necessary for the delicate use of our thumb and fingers.

Over time the tendons in our wrist can become swollen either from heavy use, repetitive use or just normal effects of aging. Exposure to heavy grasping and/or vibration can also be activities that lead to carpal tunnel. There are also certain disease states that can create more swelling in the hand such as pregnancy. The swelling within the carpal tunnel causes compression on the median nerve which makes it harder for the nerve to transmit signals from the hand up to the brain. This compression decreases the blood flow to the nerve and helps to create the sensation of the fingers falling asleep. Because the median nerve feeds the thumb, index finger, middle finger and the thumb side of the ring finger it is these fingers that are most often irritated in carpal tunnel syndrome. Sometimes all of the fingers are involved and other times just one or two can be involved depending on where the nerve itself is being compressed.

So what in the world can I do to fix this problem?

Well, there are many treatments mentioned on the Internet to cure carpal tunnel syndrome. Things like massage, anti-inflammatories, supplements, stretching exercises, yoga, braces and even meditation have been mentioned as potential methods to relieve the symptoms of carpal tunnel. While it is probably true that in very mild cases some of these interventions may be useful, unfortunately most of the time when symptoms become present on a regular basis surgery is the most predictable way to relieve symptoms of carpal tunnel. Let’s pause there for a second. SURGERY?? That sounds crazy. You have heard of people having carpal tunnel surgery with a 6-inch-long incision and having to wear a cast for 6 weeks afterward. Yes, that is a historically accurate way to describe carpal tunnel surgery, but fortunately times have changed.

These days it’s really not a surgery as much as it is a minor procedure. More on that below. The main purpose of any treatment for carpal tunnel is to address the pressure on the median nerve. It is important to either decrease the size of the tendons so as to reduce the swelling within the carpal tunnel or to create more space within the carpal tunnel. Things like anti-inflammatories and Cortisone injections and even bracing and stretching can help to decrease the swelling within the carpal tunnel but often times these interventions are temporary as the swelling will just come back over a period of time. The only known permanent fix for carpal tunnel is to increase the size of the tunnel by opening up the ligament on the roof of the carpal tunnel. By opening up the carpal tunnel, the pressure on the median nerve is decreased and it can transmit signals once again without being impeded by the swelling from the tendons and other contents of the carpal tunnel.

So how does this tunnel get opened up?

There are a number of ways that a surgeon can relieve the pressure within the carpal tunnel. All of them involve some mechanism of releasing the ligament that creates the roof of the carpal tunnel. Most often this is done under direct visualization using what is termed a mini open approach. This involves the placement of a 2 cm incision in the palm of your hand essentially right in the middle of your palm. The surgeon will carefully identify the thick ligament called the transverse carpal ligament and will use a surgical scalpel and a pair of scissors to carefully cut the ligament while directly seeing the nerve and protecting it from damage, and therefore relieve the pressure that it is compressing the nerve. Sutures are used to close the skin and these are dissolvable sutures. A bandage is placed and you can start using your hand right away. It may take up to 6 weeks to regain your strength, but your hand will be quite functional in the first week.

You might ask, “what will happen now that this ligament is gone?” And the answer is a simple nothing. A person’s body can adapt to this ligament being cut without any issues and patients are able to regain normal strength in their hands and return to normal function typically within 4 to 6 weeks after surgery. The long-term effects of carpal tunnel release are typically excellent in 95 to 99% of patients. It is true that carpal tunnel syndrome can return after a period of time but most often this is 15 to 20 years or more after their initial operation. Most people will notice an improvement in the numbness and tingling in their fingers within the first week or two after the procedure is performed. If a person’s symptoms were very severe prior to the procedure it sometimes takes longer to notice a difference and on rare occasions the symptoms get worse before they get better and this usually lasts a short period of time after the procedure like two or three weeks.

So when should I get my carpal tunnel fixed?

When a patient starts to have symptoms consistent with carpal tunnel syndrome on a regular basis, for instance 3 to five times a week I recommend considering releasing your carpal tunnel. The goal is to relieve the pressure on the median nerve before your symptoms become truly constant. We see patients from time to time that have numbness and severe tingling in their hands 24 hours a day and this indicates a level of pressure on the nerve that is likely to create permanent numbness within a month or two of starting. If we can get the carpal tunnel released before symptoms get this bad our chance of success at surgery is much improved.

If you are having symptoms on a regular basis, call your local orthopedic surgeon hand surgeon so that you can be evaluated for carpal tunnel syndrome and the options can be discussed with you. Most patients can return to work within a week or two after surgery and complete recovery typically is around six weeks postoperatively.

I hope this information has been useful for you and should you have any further questions please don’t hesitate to contact us at Wisconsin River Orthopaedics 715-424-1881. Let me know if we can help.


Frank Walter, MD
Dr. Walter is an orthopaedic surgeon who specializes in hand, shoulder and elbow surgery.