Carpal tunnel syndrome is the most common hand pathology, especially among women as they are affected eight times more than men.
The first effects of this pathology are the disablement of a correct use of the hand and its tingling during the night. This signals that something is not working efficiently in the median nerve, as explained by Dr. Davide Smarrelli, head of the Operative Unit of Hand Surgery at Humanitas Gavazzeni Bergamo.
What does carpal tunnel syndrome derive from?
‘It arises from a compression of the median nerve that runs through the carpal canal – which is placed at the base of the wrist – along with all the tendons of the fingers. When volumes change within the canal, the tendons adapt because they are elastic, while the median nerve suffers and tends to degenerate causing the typical disorders of this disease’.
What does the contraction of the carpal tunnel space depend on?
‘The fact that women are more affected could be due to hormonal issues. Among the causes, however, there can also be traumatic events such as the fracture of the wrist or continuous micro-traumas due to prolonged use of the hand for work-related issues, which contribute in creating chronic inflammatory processes that affect the nerve. Other causes can be systemic diseases such as diabetes and rheumatoid arthritis’.
Why does the tingling in the hand occur especially when we sleep?
‘Because when we sleep, we usually do it in a fetal, collected position. Thus we tend to bend our hands and wrists when we move during the night. Nocturnal flexion of the wrist can also cause a seven times higher nerve compression than during the day. The nerve, which already has a complex structure, after a while doesn’t tolerate the assumed position, and therefore it is likely to “go numb”, and the tingling derived from it wakes us up‘.
How to prevent carpal tunnel syndrome?
‘By recognizing its effects in the initial phase, when they are not persistent yet. Early diagnosis must be accompanied by appropriate physiotherapy measures of fundamental importance. If the syndrome has already developed but is still in a phase that does not require surgery, the therapies may include thermal therapies and muds. Finally, infiltrations can be effective in reducing pain, as long as there is enough space to intervene, which is not always possible due to the small size of the hand joint’.