THE SYNDROME

This syndrome is one of the most common entrapment syndromes of a peripheral nerve. In this syndrome, a nerve in the hand (the median nerve) is trapped at the level of the wrist. The median nerve is one of the three major nerves of the upper limb and is involved in the mobility and sensation of the hand limb. Because it passes through a narrow area of the hand, the carpal tunnel, which consists of the bones of the wrist and a transverse ligament, if for any reason there is any inflammation in the area, the nerve is pressed and gives symptoms in the fingers.

The syndrome occurs more often in women (who naturally have a narrower wrist than men), in pregnancy, when there is diabetes, in thyroid disorders, in rheumatism, in obesity, in joint injuries. It is also common in people who use a computer a lot or who type regularly. The symptoms are numbness in the fingers (in the first three or all), pain that may also radiate over the wrist, difficulty in the patient performing some delicate functions (e.g. buttoning) and objects may fall from the hand. In general, the symptoms are more intense at night, for an unknown reason. They worsen with movements (driving, holding a book-newspaper-phone). In the 65% of the cases they concern both hands. The patient usually copes with the symptoms by repositioning the arm or flicking the wrist.

DEALING

Treatment of the syndrome, when it is in a mild stage, is done with anti-inflammatory drugs and special splints. However, if it is in an advanced stage or the symptoms are very intense, the patient should undergo surgery on the wrist. These operations are performed under local anesthesia by orthopedic or neurosurgeons or plastic surgeons.
The only way to diagnose this syndrome is with a neurophysiological test by a neurologist. Correct diagnosis is of great importance, because many times the symptoms can be from the neck and the patient has no reason to undergo surgery. The neurologist can also determine the degree of nerve pressure and monitor it over time.