Carpal tunnel syndrome is a widely prevalent medical condition that affects both genders, albeit more frequently in women. It is characterized by the median nerve compression that passes through the carpal tunnel from the wrist to the hand.
Symptoms to Watch Out For
The primary symptom of carpal tunnel syndrome is nocturnal paresthesia, commonly referred to as nighttime tingling, in the fingers of the affected hand. Seeking the advice of a specialist is crucial if you experience this symptom. The tingling sensation is due to decreased blood supply to the nerve, resulting in nerve damage. Inflammation of the flexor tendons is the leading cause, as it reduces the space available for the nerve, causing mechanical compression.
Diagnostic Confirmation and Causes
Electromyography is a specific diagnostic examination that confirms the diagnosis and determines the severity of compression. In 90% of cases, the exact cause of tendon inflammation leading to nerve compression remains unknown. However, potential contributing factors may include manual labor in cold environments, repetitive movements, prolonged incorrect postures, or hormonal imbalances during certain life stages like pregnancy or menopause. In a small percentage of cases, anatomical causes such as cysts, neoplasms within the canal, acute traumatic events, or poorly healed fractures can be identified as the primary source of nerve compression.
Addressing Carpal Tunnel Pain
Neurological pain associated with carpal tunnel syndrome often responds inadequately to anti-inflammatory drugs, pain relievers, and standard physical therapies. Initial treatment options may involve using a positional brace that restricts wrist flexion. This helps alleviate pressure on the nerve and provides pain relief. However, the brace is not a permanent solution as it cannot address the underlying mechanical compression from the outside.
Brace or Surgery: Choosing the Right Approach
The decision between conservative (non-surgical) treatment and surgery is determined by the patient’s case, assessed during a specialist visit. Conventional treatment with a brace is suitable for the condition’s early stages and when electromyography shows initial signs of median nerve distress. The brace should be made from lightweight, breathable materials to ensure comfort during wear. Surgery becomes the most suitable option if conservative treatment fails or if there is severe nerve compression or persistent symptoms. The surgical procedure involves making a small, approximately one-centimeter incision at the wrist level and endoscopically opening the transverse carpal ligament that closes the carpal tunnel. This procedure takes about two minutes, does not require stitches, and allows hand usability on the same day.