CARPAL TUNNEL SYNDROME

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Nervus medianus develops, along with 9 tendons, in a cavity called carpal tunnel on the innards of carpus. Ailments due to nerve compression in here is called carpal tunnel syndrome.

Median nerve passes through the space called carpal tunnel in the inner side of the wrist among with 9 tendons. The diseases caused by compression of the nerve in this region or exposure to a pressure are called carpal tunnel syndrome.

Mostly exact reason can not be found. Carpal tunnel obstruction by any reason causes a pressure on the nerve and this causes symptoms appearing. Thickening of transverse carpal ligament which forms the roof of the tunnel, swelling of tendon sheathes in the tunnel, masses that causes obstruction, pregnancy and some hormonal changes are most frequent reasons of this syndrome. 

Carpal tunnel syndrome causes pain, quick exhaustion when doing hand works, numbness and loss of sense in the thumb, index finger and ring finger. Lysis may be seen in the muscle stigma on the bottom of the thumb. Existence or increase of symptoms especially in the night is typical. In advanced cases symptoms diffuse to whole day.

The disease is generally diagnosed by EMG (electromyography) test by neurologists. In suspicious cases, additional radiological examination may be required to reveal old bone fractures or possible masses.

In some cases, wrist splinter may moderate or abolish symptoms. Steroid injections may decrease swellings around the nerve and help regressing the symptoms.

Surgery is required for carpal tunnel syndrome which progresses against conservative preventions and lasts for a couple of months. Carpal tunnel Access is performed with a cut between the palm and the wrist and transverse carpal ligament which forms the roof of the tunnel is liberalized. In advanced cases, neurolysis (nerve liberalization) to the thickened nerve sheath of the median nerve under the microscope. Therefore, the pressure around the nerve is put away. Endoscopic carpal tunnel surgery (closed method) may be applied in selected cases. But, all of the symptoms may not be removed in some severe and delayed cases.


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