Carpal Tunnel Syndrome
Carpal tunnel syndrome is a compression of the median nerve in the wrist and hand. This nerve crosses the wrist through a tunnel together with all the tendons for the fingers. This tunnel is very tight and when the pressure inside increases (when the wrist bends up or down) the nerve is compressed.
Carpal Tunnel Syndrome Symptoms
The most common symptoms of a carpal tunnel syndrome are present in all fingers, except the small finger, including:
- Decreased sensation or numbness on the thumb, pointer finger, middle finger and half of the ring finger.
- Tingling on above mentioned fingers and thumb.
- Pain on the above mentioned fingers, thumb and the hand.
- Usually, this numbness and tingling are worse during the night causing the patient to awake several times.
- To relieve the symptoms, especially at night, the patient has to shake his or her hands.
- In severe cases, the muscles that allow moving the thumb to touch the small fingertip disappeared.
Diagnosing Carpal Tunnel Syndrome
Carpal tunnel is diagnosed when most of the symptoms described above are present. In addition, a test called EMG/NCT (electromyography and nerve conduction test) is used to confirm the diagnosis and determine the severity of the problem.
Treating Carpal Tunnel Syndrome
The treatment options include both non-surgical and surgical options:
This includes pain medication such as ibuprofen and some vitamins such as vitamin B to help the nerve heal. Also, some physiotherapy and exercises to allow the nerve to glide better along the wrist joint can be helpful. It is recommended to use a wrist split at night to prevent bending the wrist up and down during the night. Additionally, a conservative treatment approach also includes a shot of corticosteroids and local anesthesia.
When non-surgical treatment has failed, surgery may be an option. Carpal tunnel surgeries involve opening the roof of the tunnel (transverse carpal ligament). This can be achieved by two different surgical techniques:
- The open carpal tunnel release, which is performed by creating an incision of about 2 to 3 cm over the heel of the hand.
- The endoscopic carpal tunnel release, which is performed through a 1 centimeter incision over the flexion crease of the wrist.
Complications from carpal tunnel surgery are very uncommon, but there is a very small chance to have them. Complications may include: infections of the surgical site; partial and complete tendon and nerve injuries; return of the symptoms; partial or no relief of the symptoms; stiffness of the wrist and hand and complex regional pain syndrome.