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Bilateral carpal tunnel syndrome occurs when the median nerve is compressed in the carpal tunnel of both wrists simultaneously. It is thought to be a repetitive strain injury caused by the overuse of the hands and wrists during certain activities, such as typing at on a computer keyboard. Arthritis and obesity may also play a role in the development of the condition. Treatment utilizes medications, splints, or braces to immobilize the wrist, and surgery to cut the transverse carpal ligament.
Symptoms of bilateral carpal tunnel syndrome may first present as numbness or tingling in the fingers. Most of the swelling of the hands and fingers associated with carpal tunnel syndrome occurs at night when the fingers curl to make a fist. This results in an increase in nighttime wakefulness because of pain and numbness caused by pressure on the median nerve.
Some people with bilateral carpal tunnel syndrome report a burning sensation along the length of the fingers and into the wrist. The numbness and pain may travel up the arm and into the shoulder over time. A person may lose his ability to open and close his hands as the condition progresses.
Treatment for bilateral carpal tunnel syndrome depends on the severity of the symptoms. Steroid injections may be able to treat the pain and improve the range of motion for some people. Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to reduce pain. Most doctors will recommend wearing a brace or splint at night to prevent the hands from making a fist while sleeping. Keeping the wrist straight increases the size of the space within the carpal tunnel, reducing pressure on the median nerve.
Ultrasound treatment may be helpful to treat the pain and numbness for some people. During this procedure, the wrist is exposed to ultrasound waves for 15 to 20 minutes at a time. Many people report relief from the symptoms of bilateral carpal tunnel syndrome after a few treatment sessions.
Surgical intervention may be necessary for some people that are unable to achieve any relief through other methods. The surgeon will make an incision in the wrist to expose the median nerve, tendons, and ligaments that run through the carpal tunnel. Another incision is made in the palm to reveal the end of the carpal tunnel process. The surgeon will then make a cut in the transverse carpal ligament, relieving the pressure inside the carpal tunnel. Most people indicate significant relief from the pain and numbness after the surgery.
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