Carpal tunnel syndrome is a severe pain condition classified as neuropathy (pathology affecting the peripheral nervous system), pressure. It arises as a result of mechanical pressure exerted on the median nerve located within the carpal tunnel – a limited space on the dorsal and lateral sides with the wrist bones, and on the palmar side with the transverse ligament.
In this space – which is an extremely precise structure – tendons of the flexor fingers (surrounded by synovial sheaths) are located and the median nerve mentioned.
Oppression that can be caused by, among others, pressure increase within the internal structures of the canal of the wrist causes, in addition to pain, dysfunction such as numbness of fingers: ring, middle and index fingers. It can also be caused by inflammation of the tendons and sudden injuries. For example, bone dislocations or fractures. When the carpal tunnel syndrome develops gradually, complaints – such as numbness or tingling – are at the beginning, they appear in the patient at night and in the morning, and they persist over time.
As a result, the precision of movements is permanently disturbed and the grip is weakened. It reflects negatively on performing even the most basic everyday activities. In the initial stage, the effects of the disorder are reversible, but if we ignore the symptoms, the consequence will be aggravation of the problem resulting in permanent inability to work.
The most effective method of treating isthmoid syndrome is surgery that allows you to restore hand dexterity. The surgical procedure is performed under local anesthesia. The doctor does two-centimeter incisions on the palm side of the hand or wrist. Thanks to this, he obtains free access to the so-called flexor cord and the transverse ligament, which is then cut.
The next stage is revision of the median nerve and its possible to release or narrowing, and then the reconstruction of the cord. Finally, the hand is immobilized with plaster for a period of about 2 weeks. The final step is to remove the stitches.
Surgery removes the symptoms of the disease, but they may disappear up to several months, at least in some of them patients will experience immediate improvement. It all depends on how advanced the disease was.
It also happens that minor complaints, such as numbness in the fingers, will last until the end of life. The discomfort may also tend to recur when the patient exercises a profession that burdened the hand. Therefore, the final result depends on the degree of disease development, but also from the further fulfillment of medical recommendations.
In our clinic, treatments are carried out by an outstanding figure of medicine – a specialist in the field of hand surgery, founder of the European Hand Surgery Center – dr. Paweł Zejler.