Let's talk aboutsymptomsof thecarpal tunnel syndrome. What is this disease, how is diagnosis and surgical therapy performed.
The term "carpal tunnel syndrome" refers to the chronic inflammation of the flexor tendon bag (tunnel) which compresses the median nerve triggering a series ofsymptomsaffecting the upper limbs (fingers, hands, elbow and sometimes shoulder).
Carpal tunnel syndrome
Therecarpal tunnel syndromeit is a neuropathy linked to an alteration of themedian nervewhich passes the so-called "carpal canal".
The median nerve, at the level of the "carpal canal" that crosses the wrist, is compressed and / or is inflamed.
The median nerve governs the sensitivity of all fingers except the little finger.
What is the carpal tunnel?
Carpal tunnel: what it is. The carpal tunnel is a constituent of the anatomy of the wrist. It is composed of carpal bones (scaphoid, trapezius, piriformis, hooked) and the transverse carpal ligament, the fibrous ribbon that constitutes the so-called "tunnel". This tunnel houses, inside, themedian nervethat different vascular and tendon structures.
Thecauses of carpal tunnel syndromehave been associated with repeated and prolonged flexion-extension movements of the wrist. These movements cause inflammation that reduces the size of the "fibrous tape" (thetunnel) and result in compression of the median nerve which triggers a series ofsymptoms.
The weary movements that cause thecarpal tunnel syndromethey are the most varied. To give some examples, this neuropathy is more frequent among bowling players, those who work at the computer with excessive use of keyboard and mouse, those who use the jackhammer, those who play the transverse flute and percussion.
Carpal tunnel: symptoms
THEsymptomsare borne by the thumb, index, middle and middle finger. An alteration of sensitivity (tingling hands) may occur on these fingers. With the worsening of thesymptoms, who suffers fromcarpal tunnelmay report wrist, elbow and shoulder discomfort.
When the carpal tunnel is at an advanced stage, the symptoms just described are accompanied by a loss of sensitivity in the thumb and the muscle portion at its base which undergoes hypotrophy. In other words, the patient loses some of the functionality of the hand and has difficulty grasping objects that can easily fall out of his hand.
THEsymptomsof thecarpal tunnelabsolutely not to be underestimated. Neuropathy could be the result of wear and tear associated with movements, but clinical statistics often see it associated with diabetes and rheumatoid arthritis (an autoimmune disease). For this reason, a careful diagnosis must be made by a specialist who will have to evaluate thesymptomsas a whole.
Carpal tunnel: symptoms
change in sensation in the first four fingers of the body described as tingling
- Numbness of the hand
often described as stiffness in the fingers
- Weaker grip
- Reduced sensitivity of the fingers
- Objects that get out of hand
- Pain in the first fingers of the hand
- Wrist pain
- Pain in the arm
- Elbow pain
- Shoulder pain
In some cases the pain radiates along part of the path of the median nerve, so patients may complain of pain in the elbow, arm, elbow, up to the shoulder.
Carpal tunnel: diagnosis and treatment
The diagnosis of thecarpal tunnelmust be entrusted to a specialist. Typically, the diagnostic tests used are:
- X-ray of the hands
It is used to refute the presence of arthrosis or fractures
It is used to identify the presence of a possible crushing (compression) of the nerve that runs through the carpal tunnel.
If the patient's clinical history presents factors of interest capable of orienting the doctor towards other pathologies, the specialist may prescribe other laboratory tests (usually blood tests). In case of inflammation and severe stiffness and otherssymptoms, the specialist may deem it appropriate to prescribe the analysis for rheumatoid factor.
Many specialists use clinical maneuvers to diagnose carpal tunnel such as:
- Phalen's test or maneuver
- Tinel maneuver or test
With the Phalen test, the specialist will ask the patient to place the palms of the hands facing (as if to recite a prayer), keeping the elbows flexed and the forearms in a horizontal position. In case ofcarpal tunnel syndrometingling should appear in the first three fingers within about a minute.
The Tinel test is performed by exerting firm pressure at the entrance to the carpal tunnel. This pressure is exerted with a reflex hammer.
In the photo above, with the red arrow, we have highlighted the median nerve which, by compressing, gives life tosymptomsof thecarpal tunnel.