How Bad is My Carpal Tunnel?

From Dr. Z - Carpal tunnel syndrome specialist

How Bad is My Carpal Tunnel?

Simply saying, "My carpal tunnel is bad!" doesn't describe the stage of your disorder. Are you in the Mild, Moderate or Severe stage?

This article outlines the various stages (or grades) of carpal tunnel syndrome. It also describes the most common ways to treat each grade.

Before getting into it, you should know that carpal tunnel syndrome is a disorder that originates from inside your wrist joint. It causes discomfort in your fingers and hand. These carpal tunnel signs and symptoms include:

Pain
Numbness
Tingling
Shooting electric shocks
Burning
Clumsiness
Hand & finger weakness

Severity stages of carpal tunnel syndrome

The severity of your condition can be categorized ("staged" or "graded') in several ways. The most common way that most doctors still use is the Disease Classification Scale. This classifies carpal tunnel into "Mild", "Moderate", or "Severe" stages. This scale is easy for patients to understand. The boundary between each stage is not well defined.

Another way to classify carpal tunnel is using neurophysiological severity. That means the disorder is graded according to sensory and motor nerve conduction abnormalities. It ranges from 0 - 6, which indicates normal to virtually unrecordable signals coming from your nerves. (No signals are not good!) This grading scale is more accurate, but more cumbersome when it comes to prescribing treatment.

Pain management clinicians prefer a hybrid classification scale. It's based on symptoms as well as neurophysiological severity. There is always some variation between symptoms and neurophysiology. But the overall correlations coincide well enough to form a multi-point sliding scale.

Alternate forms of this scale are called the Levine Scale , CTS-6 Scale , and the Padua Severity Scale. Values range from normal to extremely severe symptoms.

In this article, we will use the most common grading system of "Mild", "Moderate", or "Severe" stages. And we will discuss the most common and effective ways to treat each individual stage.

Want to know how severe your carpal tunnel really is?

Take this 60 second Quiz designed by Dr. Z.

Click here to take Quiz

A note about treating carpal tunnel with surgery

Basically, there are 2 forms of surgery to relieve carpal tunnel syndrome:

Endoscopic carpal tunnel release surgery - Offering a lesser amount of trauma, and therefore a lesser degree of pain and shorter recovery time. There are 2 sub-forms: single or double portal techniques.
0pen carpal tunnel release surgery - While more widely used, may result in more hand trauma, pain, and recovery time.

The main problems with surgery are multi-fold:

Overall, surgery is about 50% effective for symptoms relief (as measured 2 years later).
Depending on the patient's health, recovery time can last many months.
There is significant down-time from work.
The post-surgical pain can be great.
There is a risk of complications like bleeding, infection, loss of strength, and persistent pain.

For the above reasons, carpal tunnel surgery is the LAST option for patients and doctors.

Mild Stage carpal tunnel syndrome

The Mild Stage of carpal tunnel syndrome is when symptoms begin to appear at night. Patients may wake up and try to shake out numbness or rub out pain.

Electrically, your nerves may show small but detectable changes in sensory nerve conduction velocity.

HOW TO TREAT MILD STAGE CARPAL TUNNEL SYNDROME

It's hard to believe, but most patients do not treat the initial symptoms of Mild Stage carpal tunnel syndrome. That's because most people don't recognize that these uncomfortable symptoms are actually the start of a serious disorder. So instead of getting treatment, most patients commonly say they overworked their hand and just need rest.

The mild stage is usually treated when symptoms become annoying enough and rob you of sleep. At that point, most patients use half-hearted remedies. These include hanging you hand off the bed to relieve symptoms. Some immerse their hands in an ice bath. But largely, most patients use drugs like Tylenol or Advil to help control the pain or numbness. And while medicines can help, the are only temporary.

When the symptoms become annoying enough, patients look to the following:

48% wear a night splint
42% get steroid shots
8% get physical therapy (including myofascial release massage)
2% get carpal tunnel surgery

Moderate Stage carpal tunnel syndrome

The Moderate Stage of carpal tunnel syndrome is when there's intermittent pain and numbness during the day. Patients also begin to experience hand clumsiness and some weakness. Dexterity problems begin (like difficulty picking up coins or buttoning a shirt). Numbness and pain are more pronounced at night. These may carry over into the day continuously or with brief periods of relief. You may feel shooting electric shocks when holding or gripping an object. Holding your hand up (like using a steering wheel or the phone) may cause numbness.

These are all signs your condition had advanced. Electrically, your nerves show diminished sensory activity which means they have already become damaged.

HOW TO TREAT MODERATE STAGE CARPAL TUNNEL SYNDROME

The Moderate Stage of carpal tunnel syndrome is when most patients begin to get serious about getting treatment. That's because symptoms have increased greatly -- usually within the last 3-6 months.

As symptoms get too intense and do not respond to the half-hearted measures, patients look to the following:

68% get steroid shots
22% wear a night splint
6% get physical therapy (including myofascial release massage)
4% get carpal tunnel surgery

Severe Stage carpal tunnel syndrome

In the Severe Stage of carpal tunnel syndrome, symptoms are intense. They interfere with your daily life and are at forefront of everything you do.

Pain and or numbness are described as punishing and crushing. Numbness is like having your hand or fingers in a vice. Hand weakness and loss of dexterity are catastrophic. Symptoms are nonstop.

Electrically, your sensory and motor nerves have barely observable activity. They are on the verge of dying.

HOW TO TREAT SEVERE STAGE CARPAL TUNNEL SYNDROME

The Severe Stage of carpal tunnel syndrome is when you have waited too long to get treatment. By now, symptoms have increased drastically -- usually within just a few months.

Symptoms will not respond to much. Patients look to the following:

42% get carpal tunnel surgery
38% get steroid shots
18% get physical therapy (including myofascial release massage)
2% wear a night splint

"End Stage" Carpal Tunnel Syndrome

While not technically a "Stage", many doctors describe some patients reaching the "End Stage" of carpal tunnel syndrome. This is when patients have lost most of their flexor tendon abilities (gripping and pinching). Thumb apposition is lost. The muscles at the base of your thumb (thenar muscles) have degenerated, and look flat or hollow. There might be constant numbness but pain generally subsides due to irreversible nerve degeneration. Electrically nerves are not recordable.

How to treat ANY stage of carpal tunnel syndrome

Myofascial release massage is the most trusted method to relieve any stage of carpal tunnel syndrome. Doctors and therapists use this non-surgical remedy for mold, moderate, and severe stages. After daily treatments for about one month, symptoms usually disappear in mild and moderate stage patients. Severe stage patients may require 2 months of treatment.

The patented CarpalRx is designed to give you myofascial release massage automatically, without the need to see a specialist. This FDA cleared medical device eliminates carpal tunnel symptoms at home, without surgery, steroid shots, or hassle.