Carpal tunnel syndrome is a disorder that occurs as a result of compression of the median nerve, which activates some muscles in the hand and carries the sensation of the fingers, at the wrist level. The median nerve enters the wrist through an anatomical structure called the carpal tunnel, which consists of the lower part of the wrist bones and the upper part of the connective tissue. The nerve may become trapped within this structure for various reasons. In this case, what we call carpal tunnel syndrome occurs.
What are the causes of carpal tunnel syndrome?
There is no specific reason for carpal tunnel syndrome, which we call primary. The disease occurs more frequently in people who use their wrists excessively (cooks, meticulous housewives, intense keyboard and mobile phone users, excessive hand knitters, etc.). It is also much more common in people with round wrists and in women. There are other underlying diseases of the type we call secondary. Diabetes, hypothyroidism and rheumatoid arthritis are common causes. Whether primary or secondary, the complaints are similar.
What are the complaints in closed tunnel syndrome?
A common complaint of patients is numbness in the hands. Since the median nerve carries the sensation of the first 4 fingers, the patient feels numbness in all fingers except the little finger. This numbness may be accompanied by symptoms such as tingling, burning, pricking and pain. Numbness is initially typical in the morning. The patient may wake up from sleep with numbness and pain in his hand, and when he shakes and moves his hand a little, the complaints improve. As the disease progresses, numbness begins to extend into the daytime. The patient may feel numbness in his hands even during an activity such as reading a newspaper. In very advanced stages, numbness in the hand increases and weakness occurs in the thumb. Irreversible damage occurs by thinning of the main muscle that elevates the thumb (image). The patient's manual dexterity decreases and he begins to drop objects.
How is carpal tunnel syndrome diagnosed?
Carpal tunnel syndrome can be diagnosed with a test called electromyography (EMG). This test is easily performed in 5-10 minutes with an EMG device. There are many diseases that mimic the complaints of carpal tunnel syndrome, and carpal tunnel syndrome cannot be diagnosed without an EMG test. Although EMG transmission studies are performed by technicians in some clinics, the truth is that the entire test is performed by a doctor who has special training in this field.
What is the treatment of carpal tunnel syndrome?
Treatment is conservative for those with mild and moderate discomfort in carpal tunnel syndrome. In cases of pain, the treatment is surgery. One of the most important points in mild and moderate cases is that if the patient makes excessive wrist movements, this should be restricted. The patient is given a bracelet to wear on his wrist at night. The patient must wear it for at least 45 days. Physical therapy applications from the wrist are partially effective. One of the important treatment options, especially in moderate cases, is cortisone injection through the wrist. Hand rest, wrist brace, physical therapy and cortisone injection constitute the conservative treatment of carpal tunnel syndrome. Surgical treatment should be considered in cases that do not respond to this treatment and in advanced cases.
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