Carpal tunnel syndrome is one of the most common hand diseases that causes pain, numbness or tingling in the hand. This problem occurs when the median nerve of the wrist or carpal tunnel is compressed. Carpal tunnel syndrome in the early stages is easily cured by performing simple treatment strategies, but if it progresses, it needs surgery for treatment. In the rest of this section, we will introduce carpal tunnel syndrome and provide you with information about its treatment methods.

 

What is carpal tunnel?

The median nerve is one of the most important nerves of the hand, which starts from the neck and reaches the wrist after passing through the arm and forearm. This nerve passes through the carpal tunnel in the wrist area and finally by passing through the palm, it provides sensation to the fingers and also controls the muscles around the fingers. In addition to the median nerve, tendons also pass through the carpal tunnel, which are called flexor tendons. Flexor tendons are responsible for bending the fingers.

In fact, it can be said that the carpal tunnel is responsible for protecting the flexor tendons and the median nerve. This tunnel is made up of a very tight connective tissue. Therefore, it has a very hard space and cannot be stretched and increased in volume. Therefore, the narrowing of the tunnel causes pressure on the median nerve and causes pain, weakness, numbness or tingling in the hand.

Causes of carpal tunnel syndrome

According to research, people who do a lot of work are more prone to carpal tunnel syndrome. In addition, this disease is more common in women and often affects the elderly. Carpal tunnel syndrome has several causes, including:

Excessive use of hands: People who work with their wrists for long periods of time are more prone to carpal tunnel syndrome. Repetitive hand movements put pressure on the nerves and cause swelling and pain.

Heredity: Heredity can be considered one of the most important causes of carpal tunnel syndrome. Research has shown that some people have a carpal tunnel that is smaller than normal from the beginning, which reduces the space of the median nerve and causes carpal tunnel syndrome.

Pregnancy: Hormonal changes are one of the things that mothers face during pregnancy. These changes cause the swelling of the carpal tunnel and eventually reduce the space of the median nerve.

Other diseases: diseases such as hypothyroidism, rheumatism and diabetes are among the diseases that may cause carpal tunnel syndrome.

Symptoms of carpal tunnel syndrome

Carpal tunnel syndrome has signs and symptoms that include:

·         A feeling of pain, numbness or tingling in the fingers that starts from the thumb and index finger and finally reaches the index and ring finger.

·         Pain or tingling sensation that starts in the forearm and slowly moves towards the shoulder.

·         A person with carpal tunnel syndrome feels weak in the tips of his fingers to the point where he has trouble closing the buttons of his clothes.

·         A feeling of weakness and laxity in the hand so that the person is unable to hold objects and causes them to fall.

The symptoms mentioned in the beginning are not permanent and appear occasionally. As the disease progresses, the condition worsens and symptoms become more pronounced or occur more frequently. The thing about carpal tunnel syndrome is that the symptoms of the disease show themselves more at night. Especially people who have a habit of bending their wrists while sleeping face severe pain that sometimes wakes them up.  

Treatment methods

When the patient encounters the above symptoms, he goes to the doctor to relieve his pain. The doctor performs various examinations and tests on the patient to diagnose the type of disease. Electrophysiology tests, nerve conduction (NCV), electromyogram (EMG), ultrasound, X-ray imaging, and MRI are some of the things that a doctor uses to diagnose carpal tunnel syndrome.

After diagnosing the disease and examining the tests, the doctor evaluates the patient's condition and considers the necessary treatment for him according to the progress of the disease. Carpal tunnel syndrome develops gradually and if it is in the early stages, it can be treated with simple non-surgical methods. In fact, the doctor tries to reduce or completely stop the progression of the disease by using a brace, doing certain exercises and sports, changing the patient's activities, etc. If the disease is in advanced stages, the doctor has no choice but to operate.

Carpal tunnel syndrome surgery

If the non-surgical treatments have no effect and the patient still faces symptoms such as pain and numbness, the doctor suggests surgery. The purpose of surgery is to remove pressure from the median nerve, which is called "carpal tunnel release". Carpal tunnel release is done in two ways:

First method: In this method, the surgeon makes a small incision on the palm so that he can access the inner parts of the hand. In this method, the two parts of the transverse carpal ligament are separated to increase the volume of the tunnel and remove the pressure from the nerve.

Endoscopic method: In this method, the surgeon uses a small device called an endoscope to view the internal components of the hand and release the carpal tunnel. The endoscope device has a camera and a light source that enters the body through a very small incision on the skin.

Postoperative care of carpal tunnel syndrome

Carpal tunnel syndrome surgery, like other surgeries, requires care, which includes:

·         Immediately after the operation, the surgeon asks the patient to hold his hand above the heart and move his fingers. In fact, this prevents the fingers from getting stiff.

·         Pain in the palm area is one of the complications after carpal tunnel syndrome surgery, which may last for several weeks after the operation.

·         Weakness and inability to pick up objects usually lasts 2 to 3 months after the operation, but in some cases it lasts between 6 and 12 months.

·         The patient must use a brace or splint for the wrist for a few weeks after the operation.

·         It is not a problem to carry out light activities and tasks such as lifting objects, driving, personal activities, etc. a few days after the operation.

·         Arthritis, tendon inflammation, weakness and pain are normal up to 2 months after the operation and gradually improve. If this time is prolonged, the doctor will suggest physiotherapy for faster treatment.