Carpal tunnel syndrome is a condition that occurs when the median nerve, one of the major nerves in the hand, is compressed and subjected to pressure within a structure called the carpal tunnel at the wrist level, due to various reasons.
Causes include repetitive hand and wrist movements (computer use, playing musical instruments such as piano or guitar, hand knitting, carpet weaving, etc.), wrist traumas, hypothyroidism, obesity, pregnancy, rheumatic diseases and tumors.
Important risk factors are heredity, older age and female gender.
Patients typically complain of numbness in the palm and fingers. Numbness is more pronounced in the thumb, index finger, and middle finger, which are the fingers innervated by this nerve. Numbness particularly occurs at night and wakes patients up from sleep. During the day, it occurs when doing works that causes the wrist to bend. In advanced stages of the disease, numbness becomes persistent, and pain in the wrist and weakness of the thumb begin. If the disease is left untreated, muscle atrophy occurs, especially in the area where the thumb meets the palm in addition to the above complaints, and the thumb becomes extremely weak.
The diagnosis is performed by some laboratory tests in addition to the patient's history and physical examination findings. The most commonly used method is electrophysiological tests. Ultrasound and MRI of the wrist can be used for diagnosis.
It is recommended to use an anti-inflammatory medication together with a wrist splint (brace) at the early stages in the treatment. The splint is worn day and night for about 20 days. In addition, corticosteroid injections and physical therapy applications can be used as other treatment options. Surgical treatment methods are applied in patients who do not benefit from these methods or in patients is diagnosed in advanced stages.
In the majority of patients with early and moderate stage of disease, symptoms can improve with these treatments in a short period of time such as 15-20 days. However, in patients with advanced stage disease and muscle atrophy, recovery may take longer and sometimes complete recovery may not be achieved. Early diagnosis and treatment are important.
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