What is Carpal Tunnel Syndrome?
It is a condition that occurs due to the compression of the structure called the median nerve, which plays an important role in the movement and sensation of the fingers, at the wrist level. It is the most common ailment among nerve compressions.
The median nerve passes through a narrow space called the carpal tunnel, along with 9 tendons that move the fingers on the inside of the wrist. Mission; It is to ensure that the entire inner surface of the thumb, index and middle finger and the outer half of the inner surface of the ring finger can be felt. It also plays a role in the work of the muscles that allow the fingers to make subtle movements. Carpal tunnel syndrome is caused when the nerve is somehow exposed to a prolonged pressure within the carpal tunnel.
Carpal Tunnel Syndrome is Common in Who?
Carpal tunnel syndrome is more common in women and between the ages of 40-60. Often no obvious cause can be found. It is more common especially in situations where the wrist is always in a bent position (using a typewriter, keyboard, etc.) or in those who work in jobs that constantly put a load on the hand and wrist.
It can also be caused by other problems such as diabetes, rheumatoid arthritis, hypothyroidism, obesity and gout. The increase in body fluids during pregnancy may cause an increase in pressure in the carpal tunnel, which may cause temporary symptoms of carpal tunnel syndrome.
What are the Symptoms of Hand-Wrist Canal Disease?
• Numbness and pain in the hands that occur at night and get worse over time. It can be bad enough to wake you from sleep and can spread to the arm and shoulder.
• Loss of sensation or electric shock sensation in palm and fingers. It is especially seen in the thumb, index and middle fingers.
• Loss of strength in the hand, inability to hold, dropping objects.
• Relief of these pains by shaking the hand.
Why Does It Happen?
Although the Hand-Wrist Canal Disease has been known by physicians for a long time, it can be confused with other diseases and most of the time, patients go around doctor-physician because they cannot get the correct diagnosis. Patients who have undergone surgery with the diagnosis of neck hernia instead of hand-wrist canal disease, but who have not been able to get rid of their complaints, are frequently encountered.
The wrist has a mixed anatomical structure. The muscle-nerve-vessel complex, which provides finger and hand movements, passes through here and disperses. The median nerve, which provides the movement and sensation of the thumb and forefinger, passes through the middle of the inner surface of the wrist and divides into branches in the hand. The upper part of this nerve is covered with a thick protective band at wrist level and partially in the palm. This protective band thickens for various reasons towards middle age and compresses the nerve that is under it and which it protects. The most common cause is band thickening due to excessive use. It occurs frequently especially in people who work for years by putting a load on their wrist, those who use typewriters and computers, housewives who knit and do intense housework, and people who use their wrists a lot, such as auto mechanics.
Sometimes this disease may appear as part of another disease.
• Diabetes Mellitus
• Hypothyroidism
• Acromegaly
• Rheumatoid Arthritis
• Like gout..
How is it Diagnosed?
Diagnosis is made by detailed history of complaints and investigating other causes that may lead to this condition. Some of the patients diagnosed with neck hernia and calcification also have hand-wrist canal disease, which is called double stenosis. There is both spinal cord and nerve root compression in the neck and wrist canal stenosis. The diagnosis is confirmed by performing neck MRI and ENMG (nerve electrode) examinations.
Treatment of Hand-Wrist Canal Disease
Initially;
• Avoiding excessive use, avoiding work that will cause excessive strain on the wrist
• Painkillers and anti-inflammatory drugs
• Wrist exercises
• Wrist splints, night splints
• Local or systemic cortisone injections are sufficient for most people.
However, over time, the complaints begin again and the permanent solution is to release the nerve with a simple surgical intervention. Under local or general anesthesia, with a 1-2 cm incision made from the wrist to the palm using a microscope, the band on the nerve is cut and the compression of the nerve is removed. This method causes lasting relief. After 3-5 days of wrist rest after the operation, the patient returns to his normal life.
