Carpal tunnel syndrome

Description

Carpal tunnel syndrome occurs due to the compression of middle nerve (nervus medianus) in the wrist. Middle nerve enables sensations in the thumb and forefinger. This nerve also controls moving of the thumb. Middle nerve passes through channel in the wrist, which is called carpal tunel, and with transversal carpal ligament forms a roof of the tunel. Swelling in the tunel causes the compression of this nerve due to which symptoms appear. Hand moves that are repeting all the time increase the possibility for this disorder to happen.

Symptoms

Wrist pain, hand pain, numbness and weakness of the thumb and first two fingers, weakened function of thumb muscle. Symptoms are getting worse at night.

Overview

Anamnesis is being taken and physical examination is being performed. Two tests are used to confirm the condition: 1) Tinel’s test – slow hitting (percussion) above the spot of middle nerve causes burning sensation and numbness in the area of thumb, forefinger and middle finger; 2) Phalen test (Phalen maneuever) – holding hand in the flexion for 60 seconds results with numbness, tingling and weakness. Examination of nerve conduction could be done to confirm diagnosis and assess severity of condition.

Tests

X-rays

Additional analyses

Electromammography

Specialists

General Practice, Orthopedic Surgery and Internal Medicine

Therapy

Treatment include: wrist immobilization, nonsteroidal anti-inflammatory drugs, such as ibuprofen (Brufen) or naproxen, painkillers (paracetamol), ergonomic spint of the arm, cortisone injections and/or surgey. Surgery can be performed by the use of open technique with open incision or through arthoscope. Both methods, intercept transversal carpal ligament releasing nerve from compression.