What is carpal tunnel (hand-wrist duct disease)?

If you spend a lot of time at the computer or work a lot with your hands, you may be overlooking numbness and tingling in your wrists and fingers.

But you shouldn’t do this because the common burning, aching or itching in your fingertips can progress and become more painful over time. Carpal tunnel syndrome is the culprit because one of the main nerves in your wrist is compressed.

The median nerve passes through a narrow space called the carpal tunnel, along with 9 tendons that move the fingers on the inside of the wrist. Its task is to make the entire inner surface of the thumb, index and middle finger feel, and the outer half of the inner surface of the ring finger. It also plays a role in the work of the muscles that allow the fingers to make subtle movements. Exposure of the nerve to prolonged pressure in the carpal tunnel in some way causes carpal tunnel syndrome.

Carpal Tunnel Syndrome Symptoms:

It can cause reactions such as numbness in the wrist, pain and weakness in the hand. He becomes unable to feel any object in the palm and fingers and may become unable to hold objects. The pain may spread to the shoulder area and arms, and its severity may increase gradually. The person becomes unable to work and often wakes up at night with pain from sleep. This stage is a serious stage.

It gives a feeling of electric shock in the hands and causes loss of strength. The person cannot lift even very light items, drop them from his hands, or not realize that the object is in his hand. There are also signs of weakness, tingling, and fatigue. Complaints such as burning, stinging and swelling in the hand are experienced. The patient cannot distinguish sensations such as hot and cold, and this may invite dangerous accidents.

The typical complaint of the patients is pain and numbness in the hand that wakes them up at night. The patient feels the need to wake up at night and shake his hands. In more advanced stages, these complaints begin to occur during the daytime.

If the nerve damage becomes permanent, numbness and loss of sensation occur in the half of the hand where the thumb is located. If the damage to the nerve continues, there will be loss of strength in the hand and difficulties in doing fine work (such as buttoning up, holding a pencil). If the crush on the nerve is not eliminated, the neurological loss may be permanent and the hand muscles may also be eroded.

Carpal tunnel syndrome that occurs during pregnancy is mostly temporary.

It develops at a rate of 1/3 – 1/4 in pregnant women. Carpal canal is affected as a result of excess water retention during pregnancy. The median nerve remains under pressure due to excess fluid. Numbness, pain and tingling are seen in the hands and fingers. It usually resolves spontaneously after birth.

As a treatment in pregnant women with carpal tunnel syndrome and excessive complaints; Methods such as not making compelling movements of the hand and wrist, using a rest splint to rest the wrist, keeping salt and water intake and weight under control, and doing wrist exercises are used.

Prevention is more important than treatment in this disease.

First of all, it is necessary to avoid works that force the hands and wrists, and not to exert excessive strain. People who use their hands and fingers for professional reasons should not keep their wrists bent all the time.

For example; In computer use, it is important to use a suitable mouse, not to lean on the table with a load on the wrist, not to lift heavy loads, not to do manual work and wringing clothes by hand. Muscles should be strengthened by doing exercises that strengthen the hand, wrist and fingers. Not leaving these points immobile are other important points in protection.

How is carpal tunnel syndrome diagnosed?

The most important factor in the diagnosis of the disease is the form of complaints and examination findings. EMG (electromyography) examination should be performed in order for the diagnosis to be certain.

It should be kept in mind that EMG may also be normal in very early periods. In patients diagnosed with carpal tunnel syndrome, it may be necessary to investigate whether there is another predisposing disease such as thyroid disorder, diabetes, rheumatoid arthritis, especially if the disease is present in both arms.

How is Carpal Tunnel Syndrome treated?

If there are underlying causes such as diabetes or arthritis, it should be treated first. Since physical activities increase the complaints, in mild cases, the affected hand should be rested for at least 2 weeks, and if necessary, wrist-wrist splints should be used. Pain can be reduced with non-steroidal anti-inflammatory pain relievers. Cortisone can be taken orally or injected into the wrist to reduce swelling and relieve symptoms. Some patients have had good results with B6 and diuretic therapy.

Treatment with stretching and pulling exercises performed under the supervision of a physiotherapist may be beneficial. The effect of complementary medicine methods is uncertain. In cases that last more than 6 months and do not respond to any other treatment, it is necessary to resort to surgical intervention. With local anesthesia, the connective tissue surrounding the wrist is loosened and the carpal tunnel is widened, thereby reducing the pressure on the median nerve. The operation can be performed in two ways, open or endoscopic. Although complaints such as pain improve in a short time after the operation, full recovery may take months.

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