Carpal tunnel syndrome (CTS)
What is it?
The median nerve, one of the main nerves of the upper extremity, responsible for sensation in the first three fingers of the hand, and to some extent, the fourth finger, and for part of the thumb’s movement function, runs from the forearm to the hand through a hard-walled canal. It shares this passage with 9 tendons that provide flexion of the fingers.
There are anatomical (especially narrow canal, increased volume of other structures that occupy it, deformation of the canal walls due to injury) or metabolic (fluid accumulation leading to tissue edema as in diabetes, thyroid disease, pregnancy, menopause...) conditions that reduce the space available to the nerve, causing it to be compressed in the canal.
In this case, the nerve function gradually deteriorates, leading to a very characteristic disorder:
Progressive loss of sensation in the fingers.
Formication in the hand, including very severe, often at night, which in the most acute cases may develop into pain and extend to the hand and shoulder.
Loss of strength and mobility of the hand in more advanced cases.
Which are the symptoms?
- formication;
- pain;
- loss of sensation;
- limitation of thumb movement.
How is it diagnosed?
Diagnosis is based on assessment of symptoms and clinical signs on examination, and is supported and confirmed by the results of electromyography, a simple study that measures nerve function.
Suggested exams
How is it treated?
In less advanced cases, conservative treatment based on rest, anti-inflammatory medications, physical therapy, and the use of fixators may be attempted.
In other cases, or if conservative treatment is ineffective, surgical intervention can correct the impairment in the vast majority of cases.
The surgery is performed by hand surgeons under local anesthesia, without the need for hospitalization, using minimally invasive techniques that allow almost immediate restoration of hand function.
The procedure is usually performed in a day hospital, and does not require hospitalization.
After the intervention, it is necessary to follow a rehabilitation program under the supervision of a hand therapist.
Where do we treat it?
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