Carpal tunnel syndrome is a disease that causes pressure on median nerve (medianus) in the carpal tunnel located at the root of the fist.
Carpal tunnel is formed by the wrist bones spanned by a tight connective tissue, transverse carpal ligament. The tendons of the fingers (flexors) and the nerve median pass through it. As the tunnel itself is tightly restricted and there is not much free space in it, pressure on the nerve is very easy which causes all the symptoms of the disease.
The pressure on the nerve is caused by all the processes that make it “tight” in the tunnel: thickening of the tendons, swelling in the area of carpal tunnel or narrowing of the carpal tunnel.
The cause of this syndrome cannot be determined with certainty. It is assumed that it is most commonly caused by a genetically inherited narrower carpal tunnel. Systemic disease, to which carpal tunnel syndrome is only a symptom, must be excluded as a cause (diseases such as: diabetes, rheumatoid arthritis, trauma, tumour, cysts, water retention in the body.
The occurrence of a carpal tunnel symptoms it is often associated with physical activities that put pressure on tendons in the carpal tunnel: keyboard work, manual work of physical workers, weight lifting, housework etc.
The symptoms of this disease develop slowly and become more severe with time:
- Transient tingling in the fingers, at the very beginning during night or in the morning after sleeping, and later numbness throughout the palm
- Pain in the area of fist that often wakes you up from sleep
- Muscular weakness of hand
This disease affects women three times more and it is assumed that the reason for this is a narrower carpal tunnel at women. It usually affects both hands, but the symptoms are stronger in the dominant hand.
CANDIDAES FOR THE PROCEDURE
Carpal tunnel syndrome treatment starts with physical therapy. If improvement does not occur with adequate physical therapy or if it the disease has progressed, surgical treatment is required.
PREPARATION FOR THE PROCEDURE
Specific preparation is not necessary for the procedure. If you take any medicines which affect the blood coagulation, it is important to avoid them several days before the procedures (such as acetyl salicylic acid (Aspirin, Andol…) martefarin and similar.
ADMISSION TO POLYCLINIC
You arrive to the Polyclinic on the day of the procedure during the morning hours, or the day before if you come from remote areas.
ANAESTHESIA
Surgery for carpal tunnel syndrome treatment is most frequently performed under the local anaesthesia.
PROCEDURE
The procedure is called decompression of median nerve because with this procedure this nerve is relieved of pressure. It consists of intersecting of the ligament that forms the arch of the carpal tunnel and, if necessary, eliminating other causes of pressure on the nerve.
IMMEDIATE POSTOPERATIVE PERIOD
The hand is sterile wrapped and painkillers should be taken for a short time. It is allowed to move fingers while avoiding obstruction of the hand.
FINAL RESULT
Majority of the patients is very satisfied with the results of the surgery and they “finally get some sleep”. Most often the symptoms disappear immediately after the procedure, but with some patients, recovery takes several weeks.
Complications are rare, hematoma is possible, and of extremely rare complications, infection, sensitivity of the scar to the touch and painful regional syndrome have to be noted. All symptoms may return if pressure on the nerve is subsequently recurrent.
