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Carpal Tunnel Syndrome – Symptoms and Treatment

carpal tunnel syndrome Korehab ClinicCarpal tunnel syndrome is one of the most common hand conditions. It is caused by pressure on the median nerve in the carpal tunnel of the wrist. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of the hand. When the median nerve is compressed, symptoms can include numbness, tingling and weakness in the thumb and fingers. Proper treatment usually relieves the tingling and numbness and restores hand function.

Symptoms of Carpal Tunnel Syndrome

Common symptoms of Carpal Tunnel syndrome are listed below. If paralysis progresses to the point where the muscles become dry, it may be difficult to fully recover after surgery.

Thumb and some of 2nd, 3rd, and 4th fingers are numb.
There is no numbness in the little finger.
Symptoms are mainly severe at night.
My fingers feel hot.
I often drop things while lifting them.
My hands feel stiff or cramp when I wake up in the morning.
Pain occurs in the wrist when the arm is raised.

Diagnosis

Treatment is often delayed because patients with carpal tunnel syndrome often attribute this symptom to other problems such as poor blood circulation. Carpal tunnel syndrome must be diagnosed by a specialist because it must be differentiated from several diseases that present similar symptoms. A neurological examination can be performed to make the diagnosis more certain. X-ray examination may be performed to differentiate it from other diseases such as cervical disc herniation. Such tests include nerve percussion test, Phalen test, and electrodiagnostic study.

Nerve Percussion Test

When the nerve in the wrist that the median nerve passes through is pressed with a finger, the area innervated by the median nerve is examined to see if any abnormal sensation or pain is induced.

Phalen Test

Examine whether pain and abnormal sensations appear or worsen in the area innervated by the median nerve when the wrist is sharply bent with the palm facing inward for about 1 minute.

Electrodiagnostic study : Nerve conduction and EMG(Electromyography) study

Examine whether there is a delay in nerve transmission speed at the wrist and whether there are electromyographic abnormalities in the thenar muscles (the bulge at the base of the thumb).

X-ray and MRI scan

Imaging tests such as X-ray or MRI may be performed to detect other diseases.

Carpal Tunnel Syndrome Treatment

Treatment of carpal tunnel syndrome is divided into non-surgical treatment and surgical treatment.

Non-Surgical Treatment

This is a possible treatment for some patients with mild symptoms and no muscle atrophy. The types are as follows:

Drug treatment using anti-inflammatory painkillers, etc.
Immobilization treatment using braces or splints
Steroid injection treatment in the carpal tunnel
Physiotherapy to open up the carpal tunnel

Surgical Treatment

The ligament that is putting pressure on the median nerve is cut. The surgery usually takes less than 20 minutes. The incidence of pain after surgery has decreased.

Indication of Surgical Treatment

Patients whose symptoms interfere with daily life or do not respond to conservative treatment
Patients experiencing persistent or progressive neurological impairment or deterioration of motor function
Patients with symptoms of worsening or weakening pain
Patients suffering from pressure due to other causes (rheumatoid arthritis, etc.)
Patients with acute symptoms (e.g., subject to immediate application) occurring after wrist injury
Carpal Tunnel Syndrome Prognosis

Prognosis

After surgical treatment, numbness and night wakings will soon disappear. However, the speed of recovery varies depending on the patient, and recovery occurs gradually. If you have suffered from carpal tunnel syndrome for a long time or have severe muscle atrophy, recovery will be even slower. Sometimes some symptoms remain. However, no matter how severe the symptoms, it is common for some degree of recovery to occur. More than 95% of patients who undergo surgery achieve satisfactory results.

Dr Jihoon Ryu Orthopedic Surgeon Korehab

Consultant Orthopedic Surgeon

2023 Hip Bioskill Course, Zimmer Biomet Institute, Bangkok, Thailand
2021 NAVIO Robotic UKA/TKA Cadaver Workshop, Seoul, Korea
2019 Z*BIKE Shoulder and elbow Update certificate
2018~2023 Consulting professor, Dept. of Orthopedic surgery Ajou University Medical Center in Suwon, Korea.
2017 Poster presentation. International Pediatric Orthopedic Symposium, Orlando, FL, USA
2017 Clinical Fellowship: Dept. of Orthopedic surgery (pediatric orthopedic) Ajou University Medical Center in Suwon, Korea..
2015 Orthopedic surgeon, UN Peacekeeping Forces in Lebanon (UNIFIL)
2013 AO trauma course certification