Carpal tunnel syndrome is a condition where the sensory nerves to the fingers become irritated, and this causes tingling in the fingers and pain in the hand, especially at night.
A large nerve runs along the arm, which branches out into the hand, where it provides sense of touch to the thumb, index finger, middle finger and half of the ring finger.
At the wrist, this nerve passes together with the tendons through a narrow, inelastic channel, where there are carpal bones on one side and a thick and firm connective tissue on the other. Swelling of the connective tissue around the tendons causes the nerve to be pinched in the canal.
Causes of carpal tunnel syndrome
The disease is very common, but it occurs most frequently in pregnant or middle-aged women. This is probably due to a change in the hormonal balance, which causes fluid accumulation in the wrists and swelling in the surrounding tissue. Carpal tunnel syndrome is also seen in connection with repeated stress on the wrists, such as in racket sports and strength training or with certain types of unilateral work.
Symptoms of carpal tunnel syndrome
Carpal tunnel syndrome causes sensory disturbances in the fingers and pain that spreads up the arm when the wrist is bent. The pain is often worst at night, when patients experience it as a tingling in the fingers that disturbs sleep, but they also often have difficulty performing a wide range of daily functions with the hand.
Treatment of carpal tunnel syndrome
There are several treatment options. You must always pay attention to whether you can find the cause of the problem. You may be able to change something about your work: aids, working position, job change, etc.
In many cases, the disorder goes away on its own. Therefore, you should initially be a little patient before proceeding with surgery.
Treatment with a supportive splint at night can help in some cases. Another method is to reduce fluid accumulation in the wrists with a diuretic. Finally, a blockade with adrenocortical hormone can provide temporary or permanent relief in some patients.
If symptoms persist for more than 3 months, surgery for carpal tunnel syndrome may be appropriate. During the operation, the nerve at the wrist is exposed to make more room. The operation can be performed as a laparoscopic operation or an open operation. With binocular surgery, the slightly larger opening of the skin over the ligament itself is avoided. Since the wound is small and not inside the palm itself, you can usually start using your hand a little earlier than after an open operation, but the end result will be the same.
Surgery with the binocular technique cannot always be carried out. For example, the method cannot be used if there has previously been a bone fracture in the wrist, or if you have previously undergone surgery for carpal tunnel syndrome.
The ligament will grow back together so the tunnel very rarely narrows again.
The pain will often disappear quickly. The sensory disturbances slow down over a period of 2 – 4 months. The strength in the hand may be reduced and will be recovered within approx. 6 months. It is important that you spare the actual wound/scar at the wrist and avoid direct pressure within the first 3 months.