CARPAL TUNNEL SYNDROME

It is a symptomatic neuropathy caused by compression of the median nerve at the wrist, characterized by evidence of increased intra-tunnel pressure and decreased neurological function.

Why does Carpal Tunnel Syndrome occur?

It is caused by an increase in pressure in the carpal tunnel, which is the space in the wrist through which the median nerve and a series of tendons pass, running from the forearm to the hand.

With this increase in pressure, the nerve receives less blood, which hinders its normal functioning and generates a series of disorders.

Risk factors for developing carpal tunnel syndrome include:

• Alcoholism

• Bone fractures and arthritis of the wrist

• Cyst or tumor growing on the wrist

• Infections

• Obesity

• Hypothyroidism

• Extra fluids that accumulate in the body during pregnancy or menopause

• Rheumatoid arthritis

• Diseases that cause abnormal protein deposits in the body ( amyloidosis )

Symptoms of Carpal Tunnel Syndrome

• The patient experiences pain in the hand, which sometimes extends to the fingers and arm. There may also be impaired hand function, such as dropping objects and loss of strength.

• In other people it is common to feel tingling, numbness and cramps in the hands during times of the day, becoming more pronounced at night.

• Often, patients suffering from this syndrome wake up with numb fingers, or with a tingling sensation in their fingers.

• In the progression of untreated pathology, loss of sensation and motor paralysis with muscle atrophy may occur.

How is it diagnosed?

Electrophysiological tests. These tests will help the doctor measure how well the median nerve is functioning and determine if there is too much pressure on the nerve.

Electrophysiological tests may include the following:

-Nerve conduction studies.

-Electromyography (EMG)

-Ultrasound.

Medical treatment

Non-surgical treatments may include the following:

• Wearing a brace or splint at night will prevent you from flexing your wrist while you sleep. Keeping your wrist in a straight or neutral position reduces pressure on the nerve.

• Non-steroidal anti-inflammatory drugs (NSAIDs).

• Changes in activity. If your work or recreational activities aggravate your symptoms, change or modify these activities.

• Steroid injections (Infiltrations)

Surgical Treatment

If non-surgical treatment does not relieve symptoms after a while, the doctor may recommend surgery.

The decision to undergo surgery is based on the severity of the symptoms: how much pain and numbness you have in your hand. In cases of long-standing, persistent numbness and deterioration of the thumb muscles, surgery may be recommended to prevent irreversible damage.

Surgical procedure

• Open carpal tunnel release surgery.

• Carpal tunnel release by endoscope

Recovery

• In general, recovery is quick, taking no more than a month. Hand movements can begin the same day as the operation, and the stitches are removed after 12 days, once the wound has completely healed. It is possible to get the hand wet from the seventh day after the operation.

• During the first month there is a certain weight restriction; you should not lift more than 5 kilos with the operated hand.

• High-intensity sports activities can be resumed two months after surgery. Post-operative physical therapy is not necessary because the surgery has a rapid recovery process, allowing the patient to return to their normal routine.

• If you experience any of the aforementioned symptoms and discomfort in your hands, wrists, and fingers, it is advisable to consult a doctor, because carpal tunnel syndrome is a condition that, when treated early, has excellent results.