Carpal Tunnel Syndrome: causes, symptoms, treatment

Carpal Tunnel Syndrome is a common condition that causes pain, numbness and tingling in the hand and arm. The situation occurs when one of the major nerves of the hand - the median nerve - is compressed to the wrist. In most patients, carpal tunnel syndrome worsens over time, so early diagnosis and treatment are important. At first, symptoms can be relieved by simple measures, such as wearing a punch or avoiding certain activities. If the pressure on the median nerve continues, it can lead to nerve damage and worsening of the symptoms. To prevent permanent damage, surgical intervention may be recommended to lower the pressure on the median nerve.

Contents Anatomy Description Causes Symptoms Diagnosis Treatment Medical Recovery Complications Results top Anatomy Carpal tunnel is a narrow wrist passage about one centimeter wide. The floor and the sides of the tunnel are made up of bones of the wrist, called carpian bones. The roof of the tunnel is a strong band of connective tissue called the transverse ligament. Because these limits are very rigid, the Carpathian tunnel has a small capacity or increase its size. The median nerve is one of the main nerves in the hand.

It originates as a group of nerve roots with a starting point in the cervical spine. These roots come together to form a single nerve in the arm. The median nerve descends on the arm and forearm, passes through the carpian tunnel of the wrist, enters the hand and is responsible for the sensitivity of the thumb and the index finger, the middle and the annular. The nerve also controls the muscles around the thumb. The nine tendons that bend the fingers pass through the Carpathian tunnel.

These tendons are called flexor tendons. Up Description Carpal Tunnel Syndrome occurs when the tunnel narrows or when the tissues surrounding the tendon of the flexors swell, putting pressure on the median nerve. These tissues are called tendonous teats. When the tendon sheath swells (swells), it occupies space in the Carpian tunnel and, over time, puts pressure on the median nerve. This abnormal pressure on the nerve can lead to pain, numbness, tingling, and weakness in the hand.

Top Causes Most cases of Carpal Tunnel Syndrome are caused by a combination of factors. Studies show that women and the elderly are more likely to develop this condition. Risk factors for Carpal Tunnel Syndrome include: Heredity; . Symptoms Symptoms of carpal tunnel syndrome may include: numbness, tingling, burning and pain - primarily in the thumb and forefinger, middle and annular; . In most cases, the symptoms of Carpal tunnel syndrome begin gradually - without a specific trauma.

As the condition worsens, the symptoms may appear more frequently or may persist for longer periods of time. Symptoms occurring at night and waking up the patient from sleep are very common. During the day, symptoms occur when you hold something in your hand for a long time with your wrist bent, back or forth, such as when you use a phone, drive or read a book. Top Diagnosis During the evaluation, your doctor will carefully examine your hand and wrist and perform a series of physical tests. Electromyographic (EMG) tests will help your doctor measure how well your median nerve works and help you determine if there is too much pressure on it.

Tests will also help your doctor determine if you have another nervous disorder such as neuropathy or other causes of nerve compression that may contribute to your symptoms. Testing for diagnosis may include: Electromyogram (EMG). An EMG measures electrical activity in muscle. EMG results can show if you have any nerve or muscle damage; . Uses high-frequency sound waves to help create bone and tissue images; .

X-rays provide dense structures such as bones. If you have limited wrist movement or wrist pain, your doctor may recommend an X-ray to exclude other causes of symptoms such as arthritis, ligament lesions or a fracture; . These studies offer better images of soft tissues of the body. Your doctor may recommend you an MRI to help you determine other causes of symptoms or to look for abnormal tissues that may compress the median nerve. An MRI can help the doctor determine if there are problems with the nerve itself - such as its scar secondary to a trauma or tumor.

Top Treatment Although it is a gradual process for most people, Carpal Tunnel Syndrome will worsen over time in the absence of appropriate treatment. For this reason, it is important to be evaluated and diagnosed from the beginning and initiated the treatment. In the early stages, it is possible to slow down or stop disease progression. Non-Surgical Treatment If diagnosed and treated early, carpal tunnel syndrome symptoms can be improved without surgery. If the diagnosis is uncertain or the symptoms are mild, the doctor will first recommend recovery treatment.

Non-surgical treatments include: Wearing an orthesis during the night will prevent you from bending your wrist during sleep. Keeping your wrist in a straight or neutral position reduces pressure on the carpal tunnel nerve; . Some patients may benefit from exercises that help the movement of the median nerve in the carpal tunnel. Specific exercises can be recommended by a physician or physical therapist; . Corticosteroid (cortisone) is a powerful anti-inflammatory agent that can be injected into the Carpathian tunnel.

Although these injections often relieve painful symptoms or help alleviate the onset of symptoms, their effect is sometimes only temporary. An injection of cortisone can help diagnose carpal tunnel syndrome. Surgical Treatment If non-surgical treatment does not relieve symptoms after a period of time, your doctor may recommend surgery. The decision to have surgery is based on the severity of the symptoms - how much pain and numbness you have in your hand. In long-lasting cases of constant numbness and wasting of the muscles of the fingers, surgery can be recommended to prevent irreversible damage.

Surgical procedure The surgical procedure performed for carpal tunnel syndrome is called There are two different surgical techniques to do this, but the purpose of both is to release the pressure on the median nerve by cutting the ligament that forms the tunnel roof. This increases the size of the tunnel and lowers the pressure on the median nerve. Surgery can be done under general anesthesia, or under regional anesthesia: just hand and arm. In some cases, you will also be given a light sedative via an intravenous line (IV) inserted into a vein in your arm. In open surgery, the doctor makes a small incision in the palm of his hand.

During the procedure, the doctor will divide the carpal transversal ligament (carpal tunnel roof). This increases the size of the tunnel and lowers the pressure on the median nerve. After surgery, the ligament can gradually increase - but there will be more space in the Carpian tunnel and pressure on the medial nerve will be relieved. Release of carpal endoscopic tunnel. In endoscopic surgery, the doctor makes one or two smaller skin incisions - called portals - and uses a miniature camera - an endoscope - to see inside the hand and wrist.

A special knife is used to divide the Carpathian transverse ligament, similar to the Open Carpathian Tunnel Release. The results of open surgical procedures and endoscopic surgery are similar. There are potential benefits and risks associated with both techniques. The doctor will talk to the patient about the surgical technique that is the best. Top Medical recovery Immediately after surgery, you will be encouraged to lift your hand over your heart and move your fingers to reduce swelling and prevent stiffness.

You must expect some pain, swelling and stiffness after the procedure. Minor symptoms in the palm may take several weeks to a few months. You may have to wear a punch for a few weeks. However, you will be allowed to use your hand for easy activities, taking care to avoid significant discomfort. Driving, self-care, lifting and gripping may be allowed shortly after surgery.

The doctor will talk to the patient about when he or she will be able to return to work and if you have restrictions on your work activities. Up Complications Although complications are possible with any surgery, the physician will take steps to minimize the risks. The most common complications of carpal tunneling surgery include: Bleeding Infection Nerve damage top Results For most patients, surgery will improve the symptoms of carpal tunnel syndrome. However, recovery may be gradual and full recovery may take up to one year. If you have significant pain and weakness for more than 2 months, your doctor may send you to a physical therapist to help you maximize your recovery.

If you have another condition that causes pain or stiffness in your hand or wrist, such as arthritis or tendinitis, it may slow your overall recovery. In long cases of Carpal Tunnel Syndrome, with a severe loss of sensation and / or decrease of muscle strength around the base of the thumb, recovery will also be slower. For these patients, a full recovery may be questioned. Occasionally, Carpal Tunnel Syndrome can be repeated, although the situation is rare. If this happens, you may need additional treatment or surgery.

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