What is carpal tunnel syndrome and what are its symptoms?
Carpal tunnel syndrome is a set of symptoms that appear when the median nerve is compressed at the level of the wrist in a channel described as the carpal tunnel.
The typical symptoms of this pathology are tingling, cramps, loss of sensitivity and even pain, which predominantly affect the thumb, index finger, ring finger and part of the middle finger, although sometimes they can appear in the whole hand and radiate to the forearm. The nocturnal onset of these symptoms is very typical, even waking the patient up several times.
What causes this pathology?
The median nerve crosses the wrist in a small passage called carpal tunnel, formed by the carpal bones and a strong ligament (transverse carpal ligament) that covers them.
This tunnel is a sealed space and when for any reason (fluid retention, inflammation, appearance of cysts, thickening of the ligament, maintained positions, etc.) the space decreases, the nerve suffers and this symptomatology appears.
Are gender and age factors that condition the development of carpal tunnel syndrome?
This pathology appears preferably in women between 30 and 60 years of age, mainly related to repetitive manual movements.
A delay in the diagnosis of this pathology is common, how can it affect the patient and what complications can appear?
It usually takes many years before patients decide to see a specialist, as the symptoms in the initial stages usually disappear by simply waving the hand and, therefore, patients delay their consultation.
However, it is very important not to delay this, because, with the passage of time there may be a loss of sensitivity or even strength, which later may not be recoverable.
The diagnosis is fundamentally clinical and is confirmed with a nerve conduction study that will tell us if the nerve is affected.
What treatments are used?
In the initial stages of the disease it is possible to make a series of ergonomic modifications in the workplace to relax the position of the wrist and to use a nocturnal wrist brace to prevent progression.
To improve symptoms in the short term and prevent progression, wrist and finger stretching exercises should be performed and anti-inflammatory drugs, vitamins and physiotherapy treatments can be added.
In cases in which the previous treatment does not improve the symptomatology and the patient presents important pain and disability, surgery may be indicated. There are different new techniques with good results such as minimally invasive surgery or endoscopic surgery, in which we open the tunnel and free the nerve from compression. It is best to talk to a specialist in hand surgery who can help you find the best solution for your specific case.