Carpal Tunnel Syndrome (CTS) is a condition that affects the hand. It consists of a compression of the median nerve in the wrist that causes numbness and tingling in the hand (especially in the thumb, index, middle and half of the ring). There may be pain, sometimes limited to the hand and wrist, but sometimes it can radiate to the forearm.
CTS often wakes the patient at night, and symptoms can appear with activities like writing, sewing, difficulty fastening buttons, driving or other activities requiring significant use of hand.
In advanced cases, there may be a loss of strength and a decrease in muscle mass at the base of the thumb.
Causes of carpal tunnel syndrome
The carpal tunnel is a channel formed by the wrist bones and a ligament (the annular carpal located on the palm side of the wrist), through which pass the tendons that bend the wrist and fingers, and the nerve ( median nerve) which reflects the sensitivity of the thumb, index, middle and ring finger part.
Some people are born with narrow tunnels and are more prone to this problem. Other times it may be by repetitive use of the hand, with tendonitis of the tendons that bend the fingers by a thickening of the tendon sheaths. Sometimes it occurs in people with some diseases that are more predisposed to suffer from this syndrome and can sometimes be the first symptom of the same as, rheumatoid arthritis, hypothyroidism, diabetes, kidney failure, etc.
Treatment of carpal tunnel syndrome
Nonsurgical treatment of Carpal Tunnel Syndrome include:
- Activity modification. Specialists in Traumatology recommend making occasional breaks and stretching in people with repetitive jobs manually. It is also important the modification of working conditions when symptoms are acquired in connection with work habits.
- Use of night splints. Position the wrist in the situation where there is less nerve pressure inside the tunnel, and can help in mild cases to reduce the symptoms.
- Corticoid infiltrations. They can usually produce temporary relief and in some patients a longer improvement.
Are potent and injected into the carpal tunnel anti - inflammatory drugs reduce inflammation of the tendons that pass through the tunnel, reducing the pressure on the nerve.
Nerve conduction studies (EMG)
They are complementary diagnostic tools that assess the conduction velocity of the median nerve signals. When there is a STC nerve conduction and electrical activity of muscles innervated by the median nerve it is abnormal slows.
The surgery involves cutting the ligament that forms the roof of the carpal tunnel, the tunnel opens and the nerve is no longer compressed. It is a simple surgery to surgeons with experience in it.
It is usually performed on an outpatient basis without hospitalization and with local anesthesia. The patient leaves the operating room with a small bandage that does not include the fingers, so you can use your hand from the start.
Postoperatively is little painful, usually it needs little pain medication.
They are usually given 3-4 points withdrawing in consultation two weeks.
The results are usually very satisfactory in general and is a surgery that has very few complications.