Carpal Tunnel Syndrome is a progressive disease that affects the first three fingers of one or both hands. It manifests itself with pain, numbness and weakness as a result of the pressure on the median nerve, which is located in the middle of the wrist and spreads to the first three fingers.
How often and at what ages is carpal tunnel syndrome seen?
It is usually more common in women between the ages of 40 and 50.
Causes of carpal tunnel syndrome
People whose wrist canal is structurally narrow are prone to the emergence of clinical symptoms. It can be seen more frequently than normal in obese people, those who drink alcohol, those with diabetes and vascular diseases. Carpal tunnel syndrome is caused by increased pressure in the canal. This pressure depends on the position of the hand. Chronic compression may occur after fractures around the hand and wrist. Infection or thickening of the tendon sheaths causes mechanical narrowing in the canal. Tumors of the nerve sheath and infections in the palm cause median nerve compression symptoms. Mechanical causes in the workplace play an active role in most cases. There is a relationship between frequent repetition of certain movements and carpal tunnel syndrome. Carpenters, tennis players, those who frequently wash dishes with their hands, drivers and those who engage in repetitive movements of the wrist are more prone. It is most commonly seen in men who are engaged in the butchery profession. It is seen in women during pregnancy. This condition is temporary. It returns to normal within a few weeks after birth. It can also be seen in people with hypothyroidism. Some other diseases play a role in the occurrence of Carpal Tunnel Syndrome. Rheumatoid arthritis, uremia, amyloidosis, vascular anomalies, Tendonitis are a few of them.
Carpal tunnel syndrome symptoms
Patients wake up a few hours after falling asleep at night with a feeling of swelling and numbness and tingling in the entire hand. The fingers are stiff, the patient feels their hand swollen and tense; but in reality, no objective change is observed. Patients shake and rub their hands, usually get out of bed and relax shortly after. Sometimes, numbness recurs many times during a night and causes serious sleep disorders in patients. Not rarely, hand numbness extends to the forearm, shoulder and neck. In housewives who use their hands a lot, the complaint increases after doing a lot of laundry and cleaning. In the later period, loss of strength and atrophy of the palm muscles occur.
How is carpal tunnel syndrome diagnosed?
When the wrist is hit with a reflex hammer, an electric shock, or shock-like response, is received in the patient's fingers. This is known as Tinel's sign. A definitive diagnosis can be made with an EMG test to a large extent. When electrophysiological and clinical findings are evaluated well, other tests become meaningless, but magnetic resonance imaging may be useful in some special cases.
Conservative Treatment
We see that night rest wristbands that keep the wrist in a neutral position but allow the fingers to be free are very useful in patients with advanced sensory and no motor disorders.After hydrocortisone injection into the carpal canal, complaints disappear for a long time. Although oral low-dose cortisone treatment has been reported to yield good results, the subsequent results of this treatment have not been mentioned.
Surgical Treatment
Patients whose complaints do not improve with drug treatment should undergo surgical treatment without wasting any more time, that is, before the nerve damage increases further. When the pressure on the nerve is removed surgically, the damage on the nerve will stop before it progresses any further. The patient does not need to stay in the hospital for this surgical intervention. In an outpatient patient, the area is numbed with local anesthesia.