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Carpal tunnel syndrome

The great “crawl

Carpal tunnel syndrome, also known as median compression syndrome, is due to compression of the median nerve of the arm. The first thing you feel is a tingling sensation running along your fingers and palm. As if thousands of ants were crawling over your hand.

Sufferers experience their hands as “asleep” and may wake up from an uncomfortable numbness, as this occurs most at night. But even during the day, the affected hand often feels numb with carpal tunnel syndrome. Some movements can only be performed in a very uncoordinated and clumsy manner. At first, it helps to shake out and move your hands again. Still, the big crawl is a serious warning sign of incipient carpal tunnel syndrome.

At the Orthopedic Center Munich East, we can help you with carpal tunnel syndrome and offer you adequate treatment tailored to your needs.

Do you need a personal consultation?

The specialists at the Orthopädie Zentrum München Ost will be happy to provide you with a medical consultation. Take advantage of our wealth of experience in the field of orthopedics and feel free to make an appointment with us!

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089 4141 434-64

Orthopädie Zentrum München Ost - Hand - Erkrankungen

Table of Contents:

Carpal tunnel syndrome – what causes can be hidden behind it?

Carpal tunnel syndrome: what is it and what helps?
How is carpal tunnel syndrome manifested?
How is carpal tunnel syndrome diagnosed?
Treatment carpal tunnel syndrome – what must be considered after surgery?

Frequently asked questions about carpal tunnel syndrome

What helps with carpal tunnel syndrome?
Can severe damage to the myelin layer be prevented by seeing a doctor in time?
Carpal tunnel syndrome – a woman’s disease?
Why are both hands almost always affected?

Carpal tunnel syndrome – what causes can be hidden behind it?

Various triggers can cause carpal tunnel syndrome, such as injuries or certain diseases. Especially fractures that occur directly at the wrist can promote the development of carpal tunnel syndrome. Other causes of carpal tunnel syndrome may include:

Rheumatism
Diabetes
Physical stress (for example, in certain occupational groups)
genetic disposition

Carpal tunnel syndrome: what is it and what helps?

Carpal tunnel syndrome is a so-called “bottleneck syndrome” and affects the median nerve (nervus medianus) in the wrist area. Pressure damage to the nerve occurs when tissue swelling occurs in the carpal tunnel. The causes of tissue swelling vary, often diseases such as rheumatism, gout, diabetes or thyroid problems are causative. Overuse of the wrist, such as constant computer work or intensive cleaning activities, increases the swelling. Bone fractures and other trauma near the wrist can also cause narrowing of the median nerve in the carpal tunnel, as can lipomas, ganglions, or osteophytes. During hormonal change phases such as pregnancy, swelling of the tendon sheaths can also occur. Other risk factors for carpal tunnel syndrome include rheumatoid arthritis and dialysis dependency.

How is carpal tunnel syndrome manifested?

Typical symptoms of carpal tunnel syndrome are numbness of the fingers, which can spread to the arm. Often there is also additional pain in the hand, especially when gripping. The first signs of carpal tunnel syndrome should definitely be observed, because constantly increased pressure on the nerve and the blood vessels supplying it leads to a reduced supply of nutrients and oxygen to the nerve. In the worst case, this can lead to permanent dysfunction.

Now the question arises, which doctor diagnoses carpal tunnel syndrome? At the Orthopaedic Center Munich East, the specialists will perform various examinations in addition to taking a medical history. A commonly performed test for carpal tunnel syndrome symptoms is the Hoffmann-Tinel sign. The physician taps the median nerve at the wrist with the fingertips. If electrifying pain occurs, the diagnosis of carpal tunnel syndrome is possible. A neurologist diagnoses carpal tunnel syndrome by measuring nerve conduction velocity (ENG) or by assessing muscle activity (EMG).

How is carpal tunnel syndrome diagnosed?

Several steps are necessary to diagnose carpal tunnel syndrome. First of all, a thorough medical history is taken to clarify questions about existing diseases, pre-existing conditions or risk factors. The second step is the physical examination, during which various tests are performed on the fingers and hands. The goal is to determine the degree of nerve damage and to be able to diagnose any sensory disturbances. Examples of tests for suspected carpal tunnel syndrome include Hoffmann-Tinel test and Phalen’s sign.

Neurological examinations may also be used to diagnose carpal tunnel syndrome. This involves measuring the conductivity and conduction velocity of the median arm nerve. Other diagnostic measures for carpal tunnel syndrome:

MRI
Ultrasound
X-ray examination

It may also be that certain functions can no longer be restored. In addition, some people have a narrowing due to a bony change in the wrist, for example, as a result of a previous fracture or rheumatoid inflammatory changes. These causes must then of course be treated as well.

Treatment carpal tunnel syndrome – what must be considered after surgery?

Depending on the extent of the procedure, immobilization may be necessary for between two days and two weeks. There is no need to wear a cast, a tight bandage is sufficient. After the operation, however, the affected hand can already be loaded quite easily. This initial load can be gradually increased during the healing process. Especially the fingers should be moved immediately after surgery. Excessive stress, such as lifting heavy loads, should be avoided during the first two weeks.

Do you need a personal consultation?

Contact

089 4141 434-64

Frequently asked questions about carpal tunnel syndrome

Many people don’t take it seriously when their hands tingle. However, doctors warn against ignoring the tingling and pain. Why?

Many sufferers are very capable of suffering. Only when they are massively disturbed in their sleep or when china has even fallen out of their hand and they can no longer get the key into the lock properly, do they go to the doctor. Or, if the pain has already become unbearable.

There is often a misconception that one operation is all that is needed. However, this is only partly the case and often does not apply. Damaged nerves heal slowly and need sufficient time for the regeneration process. This is related, for example, to the fatty layer, the so-called myelin layer. If this layer has been too badly affected, the conductivity and function of the nerves in this area will remain permanently impaired. In this case, vitamin B complex preparations can be used for several months, which positively influence nerve regeneration.

What helps with carpal tunnel syndrome?

The treatment of carpal tunnel syndrome depends on the duration and intensity of the symptoms. Initially, carpal tunnel syndrome treatment without surgery is targeted. Non-steroidal anti-inflammatory drugs are used to relieve inflammation and pain, and immobilization of the forearm also leads to improvement. Sometimes cortisone injections are also used.

If neurological deficits in grasping and pain already occur, which severely impair the quality of life, the carpal tunnel syndrome must be treated by surgery. This reduces pressure on the median nerve by cutting the carpal ligament. General or partial anesthesia for carpal tunnel syndrome is used for open surgery, but endoscopic surgery is also possible. Recovery from carpal tunnel syndrome after surgery is possible in most cases. Sometimes the complaints recur, this can not be predicted.

When you can return to work after carpal tunnel surgery also depends on what activity is performed. Sick leave of 3 to 5 weeks can be expected. At the Orthopaedic Center Munich East, you will also learn which exercises should be done and when after surgery for carpal tunnel syndrome.

Can severe damage to the myelin layer be prevented by seeing a doctor in time?

Yes, because there are various conservative therapies that make surgery circumventable. These include, for example, special splints or physiotherapeutic exercises. Certain medications, such as corticosteroids, can also provide relief for early-stage carpal tunnel syndrome. The carpal tunnel syndrome guideline makes it possible to classify the respective stage.

Carpal tunnel syndrome – a woman’s disease?

With 120,000 procedures per year, carpal tunnel surgery is one of the most common operations in Germany. Experts believe that about 30 percent of Germans suffer from carpal tunnel syndrome. Women are three to four times more likely to be affected than men, and most sufferers are between 40 and 70 years old. In particular, people who work hard with their hands are often affected, as are athletes such as ice hockey or tennis players.

Why are both hands almost always affected?

Because you use both hands almost equally. Unconsciously, one hand is spared and activities are shifted to the other hand, so that the latter is then more heavily used. The change happens automatically. For a right-handed person, for example, the left hand is responsible for holding and is exposed to a greater load. The right hand is more responsible for fine motor skills.

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