Carpal Tunnel Syndrome is an entrapment of the median nerve as it passes through the wrist. It affects 3% of the population in their lifetime, but up to 5% of women, who suffer from it more than men, and manual workers.
Carpal tunnel: symptoms and causes
Patients who suffer from this syndrome when they go to the orthopedic surgeon’s office present numbness of the first three fingers of the hand and part of the fourth finger as the main symptom. They also have loss of strength, tingling or discomfort at night or when doing repetitive activities that make them have to get up and move their hand.
More and more cases are occurring due to the so-called “technopathies”. We continually use keyboards, mice, telephones and perform actions that cause us to have our wrists in forced positions, compressing the nerve. Carpal tunnel syndrome affects those professions in which they have to repeatedly use the hand for power work or tapping or other activities of this type.
Patients with rheumatic diseases or endocrine diseases such as hypothyroidism, rheumatic arthropathies or also pregnant women, present more frequently this clinical picture.
Carpal tunnel: diagnosis
The diagnosis is established by clinical examination with a series of maneuvers, compression or forced flexion that the physician must interpret in an attempt to provoke or accentuate the symptoms that our patients complain of.
It can also be confirmed by electromyography, but in up to 10% of the cases the electromyography is normal, because the patient has a dynamic carpal tunnel syndrome, only in those positions in which the nerve is being stretched. Treatment by means of conservative measures: correction of posture, strengthening of the musculature has relatively regular results.
Carpal tunnel: treatment
The most effective treatment is the release of the carpal tunnel that can be done by conventional surgery more or less invasive, with incisions ranging from 4-5 cm to 1-2 cm. All these incisions and this type of surgery requires: leaving the hand without blood supply, anesthesia of the whole arm, deeper, stitches and recoveries are much longer, between one month to three months, depending on the picture.
Currently, this syndrome can be treated by ultra minimally invasive ultrasound-guided surgery that involves anesthetizing only the area where the nerve is compressed, without ischemia, put the ultrasound over and with an incision in the wrist of one millimeter, which does not require stitches, we introduce the special scalpel and release the carpal tunnel. Thanks to this technique we are able to operate on both hands at the same time. The advantage is that the patients move their hand, they use it immediately after finishing the operation and many of them, if they do not have problems with weight bearing, do not need any day off work.