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Carpal Tunnel Syndrome is a condition brought by an increased compression of the median nerve at the wrist level due to tendons inflammation, joint dislocations, fractures.
Symptoms are usually numbness, pain at the level of the median nerve territory that includes the thumb, index, middle and ring finger. They are often felt during the night, but also during daily activities such as reading a newspaper, driving.
A weaker grip could be present.
In most severe cases atrophy of muscle at the base of the thumb appears and sensation may permanently lost.
It may be present during pregnancy, because of fluid retention: in this latter case symptoms usually disappear after delivery.
A proper history and clinical evaluation are in most cases sufficient for the diagnosis; electromyography confirms the severity of the condition; in some cases X-ray and other instrumental evaluation could be helpful.
Treatment
Conservative treatment as first step is mandatory.
It consists in wearing a resting night splint, non steroid anti-inflammatory drugs and changing the patterns of hand use.
In case of failure, surgery may be needed. The decompression of the nerve can be performed with the endoscopic technique: this procedure, performed in local anaesthesia, lasts about 5 minutes in day surgery regimen: no suture is needed.
The use of the hand is allowed right after surgery for daily life activities. An important role is played by few session of hand therapy.
