It is a disease that causes symptoms such as pain in the wrist and hand, numbness in the hand and arm, especially at night, decreased dexterity, as a result of the compression of the median nerve going into the hand under the ligament called carpal in the wrist. Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy and is seen in 1% of the general population, 2% of the adult population, and approximately 5% in people who use the wrist frequently with repetitive movements. It is seen 2-5% more in women than in men. It is frequently seen in the dominant hand in women between the ages of 55-65, and bilaterally in 10% of the cases.
In most cases, the cause is unknown. In 5-10% of the cases, there is a history of trauma to the wrist region. Occupational repetitive microtraumas are among other causes. However, it can occur due to many systemic diseases such as Rheumatoid arthritis, Chronic kidney failure, Dibetes Mellitus, Gout disease, Amyloidosis, etc., and tumors in the wrist region.
The patients are generally middle-aged women with complaints of burning pain in the hand and wrist, numbness in all fingers except the little finger. Early symptoms, night pains and numbness, wake the patient from sleep, the patient tries to reduce the pain by raising or shaking his hand. Pain often radiates to the elbow, sometimes to the shoulder. Over time, weakness occurs in shaking hands and grasping. Late findings are melting of the muscles leading to the thumb (thenar region) and weakness in the movement of the thumb towards the palm, which develops within days.
An electrophysiological test called EMG is most commonly used for diagnosis. The most frequently confused disease is neck hernia, that is, cervical disc herniation. There are two types of treatment for carpal tunnel syndrome. The first of these is conservative treatment in mild cases and in patients without EMG pathology. These are avoiding certain activities, using wristbands, regulating occupational and daily life activities, and drug therapy. Surgical treatment is applied in advanced cases and in patients with EMG pathologies. Surgical treatment methods are divided into open surgical techniques and closed surgical techniques.
References
1- Turkish Neurosurgery Society Books Basic Neurosurgery Book
