Carpal tunnel syndrome

When the median nerve in the wrist becomes compressed, this is known as carpal tunnel syndrome. The pressure exerted on the nerve causes sensory disorders in the hand such as a tingling sensation or numbness. The condition can be treated using conservative and surgical measures.

The median nerve and various tendons run along the inside of the wrist (carpus) through the carpal tunnel. There are a number of reasons why the carpal tunnel may become compressed and exert pressure on the median nerve. Often, inflammation of the flexor tendons caused by increased usage is responsible for the development of the carpal tunnel syndrome. Frequent typing on a computer keyboard is an activity commonly known for causing the tendons in the wrist to become inflamed. Other possible causes include swelling after injuries or a broken wrist, or rheumatic diseases. However, very often the syndrome develops for no discernible reason. Overall, women are affected more frequently than men and this is thought to be due to hormonal differences.

Hand pain and sensory disorders are typical symptoms of carpal tunnel syndrome. They manifest as a tingling sensation, pins and needles, numbness or loss of feeling in the fingertips. Such disorders are sometimes accompanied by burning pains that can extend all the way down the arm. The symptoms are typically worse at night or when the hand stays in the same position for long periods of time.

Carpal tunnel syndrome is diagnosed on the basis of its characteristic symptoms and through the use of special examinations. These include testing the hand’s nerve function (electroneurography) and muscle function (electromyography) by stimulating the nerves and muscles with electrodes. An ultrasound examination can be used to identify compression of the carpal tunnel.

Carpal tunnel syndrome is generally treated conservatively in the first instance. The wrist is immobilised using a brace or bandage. At the same time, the inflammation of the flexor tendons is treated with anti-inflammatory medication or local injections of cortisone. The earlier the conservative treatment is started, the better the chances of recovery. So it is important to have any problems promptly checked out by a doctor.

If conservative treatments do not fully resolve the symptoms, it is usually necessary to have an operation. During surgery, the carpal tunnel is opened and the pressure on the nerves is manually relieved. This procedure can be carried out using a minimally invasive endoscopic technique.