Carpal Tunnel Syndrome, or "When Your Fingers Go Numb"

Information

What is Carpal Tunnel Syndrome?

Numbness in the first three fingers of the hand is a common occurrence. The condition is called "Carpal Tunnel Syndrome" and represents compression of the median nerve of the hand (n. medianus) within an anatomical closed structure of the wrist and palm called the carpal canal or tunnel. The tendons of the finger-flexing muscles and the nerve pass through it. Under certain conditions (inflammation, hormonal changes, diabetes, after injuries and fractures, and very often without a clear cause), swelling occurs, which raises the pressure in the tunnel and impairs the metabolic processes in the nerve tissue. Nerve conduction slows down, and numbness is felt in the thumb, index finger, middle finger, and part of the ring finger.

Do you have observations on the cases in which this condition most commonly occurs?

Those affected by this condition are predominantly women around and after menopause. Younger people are not spared either, nor are men, especially those with significant strain on the hands. The frequency is higher among people with diabetes mellitus and those undergoing hemodialysis treatment.

What symptoms characterize Carpal Tunnel Syndrome?

Nighttime and early morning pain is very characteristic, when the patient wakes up with numb hands and has to shake them to make this extremely unpleasant sensation pass. Sometimes there is diffuse, poorly defined pain throughout the entire upper limb, even in the neck and part of the back. Unfortunately, the condition cannot heal on its own, that is, it cannot pass "by itself," because within the enclosed space of the carpal tunnel a vicious cycle of nerve compression and inflammation of the surrounding tissues develops. When the compression continues for a sufficiently long time, difficulties with fine motor movements, clumsiness, difficulty with self-care, dropping objects, weakness in the hand, and "wasting" (atrophy) of some of the small muscles of the palm are added to the sensory symptoms (tingling, numbness, altered sensation). These changes indicate that the compression has been long-standing, and recovery in such patients is more difficult.

How is the condition diagnosed?

Making the diagnosis is easy given the typical symptoms and the use of certain provocative tests. In addition, specific electrophysiological studies can be performed that objectively assess the changes in conduction along the affected nerve. This study is called electromyography (EMG) and is carried out in specialized laboratories. Unfortunately, a considerable proportion of patients are still delayed at various levels, being diagnosed with "tendovaginitis," "poor circulation," "neck spurs," or even "insomnia and neurosis," and in this way treatment is delayed while the nerve suffers permanent damage.

What are the methods for addressing the problem?

Even when correctly diagnosed, many patients are offered an inadequate solution, which also wastes time and worsens the long-term prognosis regarding nerve recovery. Taking medications, vitamins, food supplements, and physical therapy cannot lead to a cure. No method of prevention for the condition is known, and the primary method of addressing Carpal Tunnel Syndrome is surgery. The dense tissue compressing the nerve is cut. Timely performance of the surgery leads to full recovery. When the surgery is delayed, recovery is slower and incomplete, but there is nevertheless significant and substantial relief of the subjective symptoms of numbness and pain. It is important that the surgery be performed by a hand surgery specialist in order to avoid complications.