Do you have limited mobility in your hand?: Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome occurs as a result of the compression of a nerve located in the wrist. Within the wrist, there is a nerve called the median nerve that transmits sensations and controls movement to the muscles responsible for moving the hand and fingers. This nerve resides in a passageway called the carpal tunnel, which is surrounded by the wrist bones and a ligament. When the volume and rigidity of the surrounding ligament increase, the nerve cannot move freely within the canal, leading to the development of Carpal Tunnel Syndrome.

What are the Symptoms of Carpal Tunnel Syndrome?

The symptoms of Carpal Tunnel Syndrome are typically associated with discomfort and impaired functionality in the wrist and hand. The following are some of the common symptoms of this syndrome:

• Numbness and tingling in the hand and fingers: Numbness and tingling sensations, especially in the thumb, index finger, middle finger, and half of the ring finger, can be experienced. These sensations may extend from the wrist to these fingers.
• Pain and burning sensation: Pain and burning sensation in the wrist and hand can occur. These sensations are a result of the compression of nerves in the wrist and tend to worsen, particularly during sleep at night.
• Weakness and clumsiness in the hand and fingers: Carpal Tunnel Syndrome can result in a feeling of weakness and clumsiness in the hand and fingers due to the compression of the median nerve that affects the hand's muscles. This can make daily activities such as gripping objects, buttoning up shirts, etc., difficult.
• Functional impairment: As Carpal Tunnel Syndrome progresses, the function of the hand and fingers can be severely affected. Decreased sensitivity and motor function of the hand may occur, making delicate movements challenging and leading to difficulties in performing certain activities successfully.

These symptoms may vary from person to person and can change depending on the severity of the syndrome. If left untreated, the symptoms can worsen over time and adversely affect hand functions. If you experience any of these symptoms, it is important to consult a healthcare professional to receive the correct diagnosis and take the necessary steps for appropriate treatment.

What are the Causes of Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is considered a complex condition that can arise from various factors. Some of these factors include:

• Structural issues in the wrist: Carpal tunnel is a space formed by wrist bones and ligaments. Structural problems in this area can cause narrowing or compression of the carpal tunnel, leading to the entrapment of the median nerve.
• Excessive wrist use: Repetitive movements that excessively use the wrist, such as continuous computer use, handling tools, frequent keyboard typing, etc., can lead to swelling and inflammation of the tissues in the wrist. This can cause Carpal Tunnel Syndrome by compressing the nerve.
• Trauma or injury: Trauma to the wrist, such as fractures or sprains, can damage the tissues surrounding the wrist, leading to narrowing of the tunnel.
• Rheumatoid arthritis and other rheumatological diseases: Rheumatological diseases like rheumatoid arthritis can cause inflammation, leading to the narrowing of the carpal tunnel.
• Hormonal changes: Hormonal changes, such as during pregnancy, can cause fluid retention and tissue swelling, increasing pressure within the carpal tunnel and compressing the median nerve.
• Diabetes: Diabetes can cause nerve damage, contributing to the worsening of Carpal Tunnel Syndrome symptoms or resulting in permanent nerve damage.
• Thyroid problems: Thyroid gland-related issues can negatively affect nerve function, leading to Carpal Tunnel Syndrome.
• Genetic predisposition: Individuals with a family history of Carpal Tunnel Syndrome may have a genetic predisposition to the condition.

In addition to these factors, age, gender, obesity, chronic kidney disease, and other conditions can increase the risk of Carpal Tunnel Syndrome. However, these factors may not have the same effects on everyone, and a specific factor may have varying degrees of influence on each individual. Diagnosis of Carpal Tunnel Syndrome should be made through examination and appropriate tests by a healthcare professional. Treatment is planned to manage the symptoms and prevent further nerve damage.

What are the Treatment Options for Carpal Tunnel Syndrome?

The treatment options for Carpal Tunnel Syndrome can vary based on the severity of the symptoms, the patient's overall health, and the underlying causes of the syndrome. The treatment aims to alleviate the symptoms, improve hand and wrist function, and prevent nerve damage. The treatment options for Carpal Tunnel Syndrome include:

• Rest and Wrist Splinting: Resting the wrist and avoiding excessive use are important. Wearing a wrist splint during daily activities can help reduce pressure on the wrist and may alleviate nerve compression.
• Physical Therapy: Physical therapists can apply exercises and therapies to strengthen and stretch the muscles of the hand and wrist, reducing nerve compression.
• Medications: Pain relievers and anti-inflammatory medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help reduce wrist swelling and inflammation.
• Steroid Injections: Doctors may administer corticosteroid injections to the wrist area to reduce swelling and inflammation temporarily. These injections can be used to relieve symptoms for a short period.
• Hand Exercises: Specific exercises can strengthen hand and wrist muscles and increase flexibility, reducing nerve compression.
• Surgery: When other treatment options are ineffective, or if the symptoms are severe, surgical intervention may be considered. The goal of surgical treatment is to release the tissue compressing the nerve within the carpal tunnel, allowing the median nerve to function normally. Surgery can be an effective method for preventing nerve damage and improving hand function.

The earlier the treatment is initiated, the better the results. Therefore, when experiencing symptoms, it is essential to consult a healthcare professional and take appropriate steps for accurate diagnosis and treatment. It should be noted that each case is unique, and the treatment plan should be personalized according to each individual's needs and condition.

How Does the Surgical Treatment of Carpal Tunnel Syndrome Work?

Surgical treatment of Carpal Tunnel Syndrome is considered when other treatment methods are ineffective or if the symptoms are severe. The surgical intervention aims to open the carpal tunnel, where the median nerve is compressed or narrowed. This is achieved by creating more space for the nerve, allowing it to function properly and preventing further nerve damage. Here's how the surgical treatment of Carpal Tunnel Syndrome works:

• Preoperative Preparation: Before the surgical procedure, your doctor will diagnose Carpal Tunnel Syndrome through examination and tests. The surgical option is evaluated based on the severity of the symptoms, the patient's health condition, and the underlying causes. Information about the risks and benefits of the surgery will be provided, considering your overall health and the medications you are taking.
• Surgical Procedure: Carpal Tunnel Syndrome surgery is usually performed under local anesthesia, which means the hand and wrist are numbed. In some cases, general anesthesia may be preferred, in which case the patient is put to sleep. The surgery is typically performed through a small incision. This incision is made on the palm side of the wrist, and the procedure can be performed using microscopic or endoscopic surgical techniques.
• Expanding the Carpal Tunnel: The surgeon carefully opens the carpal tunnel in the wrist, creating more space for the median nerve. This reduces nerve compression, helps correct nerve transmission, and may alleviate symptoms.
• Wound Closure and Stitches: After the surgical procedure, the incision is closed using stitches. In some cases, self-absorbing stitches may be used, eliminating the need for stitch removal later.
• Postoperative Care and Recovery: The surgical procedure typically allows for discharge on the same day. Avoiding pressure on the hand and keeping it elevated can help reduce postoperative swelling. Physical therapy and hand exercises can help strengthen hand muscles and promote complete recovery.

The postoperative recovery period may vary from person to person, but in general, individuals can return to normal daily activities within a few weeks. The complete recovery period can vary depending on the complexity of the surgery and the patient's overall health.

Postoperative complications are rare, but like any surgical procedure, there are risks such as infection, wound healing problems, or nerve damage. Therefore, it is essential to have a detailed discussion with a neurosurgeon regarding the risks and benefits of the surgery before opting for the surgical option.