About the disease
Carpal tunnel syndrome is a damage of arm`s nerve endings due to compression of pinched nerve in the wrist. The carpal tunnel is a passageway which connects palm with the wrist and protects main nerve between hand and fingers. Carpal tunnel syndrome can develop because of certain health problems, wrist fracture and congenital anatomy of wrist. In some cases inflammation and rheumatoid arthritis can contribute to development of carpal tunnel syndrome. According to National Institutes of Health, 81.5% of carpal tunnel pressure cases are caused by unhealthy lifestyle, smoking, obesity, alcoholism, 8.29% - by repetitive job, where wrist is constantly fixated in the wrong way, 5% - by excessive consumption of caffeine.
At first it affects fingers and then starts to cause discomfort in wrist, which disables a person to move it freely. After that, begins the stage of numb and painful sensation in the arm, when a person tries to hold telephone or drive a car. At the end, sensation can become strong enough to constantly wake a person during the night. There are acute and chronic types of this syndrome. The first type is much less common and it develops rapidly resembling infection by its symptoms. The second type can develop for months until it requires surgical intervention. Carpal tunnel syndrome is more common in women.
Symptoms
- Arm numbness
- Weakness
- Troubled night sleep
- A person keeps dropping relatively small objects
- Pain in fingers
Diagnosis
- Physical examination can usually determine if there is problem with nerve endings of an arm. Doctor examines each finger by pressing on them to assess its sensitivity and muscle strength.
- Nerve conduction test uses electrodes which are connected to the skin. After this a person is given mild electrical shock to see if it is slowed in the carpal tunnel and what can be the reason for that.
- X-Ray of the wrist is ordered if person had arm fracture previously and there is suspicion that wrist bones were damaged and thus affected carpal tunnel.
Treatment
Surgery treatment is recommended if symptoms became severe and can not be stopped by anti-inflammatory drugs and wrist splints. During such surgery, doctor cuts the ligament which creates pressure on median nerve and causes pain. There are two main types of surgery which can relieve median nerve pressure. Those are:
- Open surgery
- Endoscopic surgery
During open surgery doctor makes an incision on the palm to access the carpal tunnel and then reaches the damaged nerve.
During endoscopic surgery a doctor inserts tiny camera into the carpal tunnel and relieve pressure by two small incisions. This procedure is less painful than open surgery.
After surgery you may need to undergo neurorehabilitation, which aims to return you full arm`s mobility and help you heal faster.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko
