Carpal tunnel syndrome of the wrist is the most common entrapment neuropathy and at the same time the most common overuse injury of the wrist. The carpal tunnel is a narrow passageway in the wrist, limited by eight wrist bones on the upper side and a transverse carpal ligament on the bottom side. Flexor muscle tendons of the wrist (9 tendons) and the median nerve that innervates the first three fingers and half of the ring finger, run through it. When the tendons of flexor muscles in the wrist become inflamed, they start pressing on the median nerve in the wrist passageway. The carpal tunnel is most often injured due to the overuse of flexor muscle.
Carpal tunnel syndrome appears most often among middle-aged women and generally among office workers since frequent typing and the use of the computer mouse overburden flexor muscles of the wrist. The reason for the development of carpal tunnel syndrome are most often unvaried repetitive movements of the wrist, hormonal changes among women during pregnancy and after it, traumatic wrist injuries, changes among women during menopause, and various diseases (rheumatoid arthritis, diabetes, thyroid disease, etc.).
The initial symptoms of carpal tunnel syndrome include tingling, prickling, and a change of sensation in all the fingers of the hand except for the little finger. The tingling and the prickling sensation of the hand or the fingers occur most often at night, which can disrupt sleep.
Towards the morning, it is common to observe numbness of the fingers and the feeling of a swollen palm. Carpal tunnel syndrome is also typically accompanied by decreasing muscle strength and occasional dropping of items. Gradually, difficulties in carrying out various daily tasks may appear, for example, house chores, using a screwdriver, lifting heavy objects, cycling, the use of a computer mouse, etc.
The diagnosis of carpal tunnel syndrome is confirmed by a neurophysiological test EMG that measures the conduction of the median nerve or the degree of wrist passageway narrowing. In the initial phases of carpal tunnel syndrome, conservative treatment is suggested with physical therapy and special exercises that aim to improve the mobility of the wrist tunnel and eliminate asymmetry in strength and the activation of muscles of the forearm and wrist.
It is recommended to wear a brace and avoid repetitive movements of the wrist during conservative treatment. We also recommend you use an ergonomic mouse for the office. If nonsurgical treatment of carpal tunnel using physical therapy is not effective or the pathology is already at an advanced stage, then surgical treatment is the best choice for the patient.
Surgical treatment of carpal tunnel is a routine procedure with a good prognosis on the effects of treatment. After the surgical procedure, the arm is secured in a brace that is usually removed after three days. Soon after surgery, the fingers are carefully therapeutically stretched until pain is felt. After three days, the patient begins with more intense exercises to strengthen the muscles of the fingers and stretching. Three weeks after the surgical procedure, the arm should be prepared for easier everyday tasks. For more difficult physical activities and sports, the arm should be prepared after a month of an adequate rehabilitation exercise programme. Symptoms such as decreased strength of the fingers, occasional tingling, and a painful scar can be present even for multiple months after the procedure and should gradually go away in a period of up to one year.
Wear a brace and avoid repetitive movements of the wrist for a long period of time. We also recommend you use an ergonomic mouse for the office.
In the initial phases of carpal tunnel syndrome, conservative treatment is suggested with physical therapy and special exercises that aim to improve the mobility of the wrist tunnel and eliminate asymmetry in strength and the activation of muscles of the forearm and wrist.