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CARPAL TUNNEL SYNDROME IS A FREQUENT LIFE DISTURBING ILLNESS

riešo kanalo sindromas, periferinis nervas, atpalaidavimo operacija, neurochirurgija, clinic agatas, mindaugas vaišvilas

CARPAL TUNNEL SYNDROME IS A FREQUENT LIFE DISTURBING ILLNESS

Carpal tunnel syndrome is one of the most common ailments associated with compression of the median nerve in the carpal tunnel. This compression causes pain in hand and wrist, numbness, weakness in fingers, and so on. This disease has a particularly negative effect on the patient’s health, not only due to unpleasant sensations but also due to loss of ability to work. Weak, painful wrists, hands, numb fingers often prevent not only from working but also from doing daily activities.

 

WHAT ARE THE SYMPTOMS OF THE CARPAL TUNNEL SYNDROME?

Carpal tunnel syndrome usually affects people aged 45 to 65, especially older women. The causes of carpal tunnel syndrome can be very diverse, not only related to physical causes, such as constant strenuous physical manual labor. It can also be affected by other diseases or disorders, such as diabetes, thyroid disease, menopausal hormonal changes, rheumatoid arthritis, and others.
Often patients who have this ailment complain of sensory disturbances, such as a decrease in skin sensitivity, or, conversely, an increase. Sensations of numbness, itching, burning, or freezing are also common. Many say that it feels like ants are crawling underneath the skin of hands. At night, severe numbness and burning pain in the wrist and hand may occur that is spreading towards the elbow or shoulder. For this reason, people who have carpal tunnel syndrome usually have insomnia. Due to this reason, a person becomes irritable, tired, more sensitive to the pain.
Fine motor skills can be impaired in the case of carpal tunnel syndrome. It can become difficult to grasp small items such as buttons, zipper heads, needles, and so on. Morning stiffness and swelling of the hands is also the symptom of this syndrome.

 

HOW IS CARPAL TUNNEL SYNDROME DIAGNOSED?

When carpal tunnel syndrome is diagnosed accurately and timely, it prevents nerve and muscle from damage, and also excellent treatment results may be achieved.
First of all, an examination by a neurologist or neurosurgeon is required. The doctor evaluates the patient’s clinical case, the course of the disease, and prescribes various clinical trials.
The specialist performs electroneuromyography to evaluate the pathology of the nerve. By this examination, the doctor identifies disorders of nerve viability and conduction in individual nerve segments. If necessary, the doctor performs an analysis in ultrasound guidance that is needed to assess the condition of the nerve, changes in tendons, and the pathological structures adjacent to the nerve. In some cases, the doctor may recommend magnetic resonance imaging. MRI shows a detailed image of nerve and surrounding structures, and also it helps to differentiate from spinal pathology, which can cause similar symptoms. The specialist may also prescribe blood tests if there is a concomitant pathology.

 

CONSERVATIVE TREATMENT OF THE CARPAL TUNNEL SYNDROME

First of all, after evaluating the duration of the disease and the degree of nerve damage, a doctor may offer conservative treatment or peripheral nerve relaxation surgery. If the condition is not chronic (lasts for weeks or months), treatment of tendonitis, blockade by a pain doctor, injection of anti-inflammatory drugs, or physiotherapy may help.
A physiotherapist can help to determine which wrist position is the most painful, and at the same time, suggests the most comfortable wrist position to reduce repetitive wrist strain while working or on daily activities.
If carpal tunnel syndrome is not chronic, mild pain and discomfort can be reduced by more frequent breaks while working. Also, in this case, wearing a wrist splint is quite effective (especially at night). However, if the patient does not feel a significant improvement after 4-6 weeks of wearing the splint, it is not worth continuing such treatment.
Usually, in the case of conservative treatment, the physician requires that the patient perform a limited exercise. To improve blood circulation and relieve the pain, some activities, massages, taking B vitamins may be offered. However, non-surgical treatments are more effective when the nerve damage is not chronic and not significant.

 

PERIPHERAL NERVE DECOMPRESSION SURGERY

When numbness or pain persists, a neurosurgeon may offer peripheral nerve decompression surgery. The purpose of this surgery is to reduce nerve compression.
The neurosurgeon makes a small incision in the palm and cuts the ligament that covers the carpal tunnel. This action increases the space in the duct and reduces the pressure. The surgeon operates under local or general anesthesia, and it is also possible to combine both of them. Before the surgery, this decision is made by a patient ant his or her treating surgeon. The duration of the operation is about 30 – 40 minutes. And 3 – 4 hours after the surgery, the patient may go home with an accompanying person.
Some patients experience relief immediately after surgery. Others may still experience numbness, pain, or weakness for some time. It is due to the experienced long-lasting nerve compression. In 3-4 weeks after the surgery, the patient can do light work. If the job requires a lot of repetitive movements or is physically strenuous, the patient should avoid performing it for at least six weeks after the operation.