The carpal tunnel or wrist median is a narrow tunnel in the wrist. The median nerve is located in this tunnel, along with nine tendons, which move the hand and fingers. It is well-protected from direct blows and can perform its tasks – the sensors are handled by the thumb, index finger, middle finger and the thumb side of the ring finger. The motor part is handled by the thumb muscles.
Pressure on the nerve leads to disturbance in sensory activity – tingling sensation and pain. If the pressure is not releases, the motor strings are also damaged and a syndrome develops, which is characterized by muscle weakness of hands and related clumsiness of the fingers, objects dropped from the hand and similar nuisances.
Often, carpal tunnel syndrome occurs together with a systemic disease, which mostly affects the joints and is known as rheumatism. It is the most common form of systemic disease of the joints, rheumatoid arthritis.
The disease begins gradually with mild pain in the wrist, which can extend to the area of the palm, on the inside of the forearm or even to the shoulders. All fingers, except the little one, experience a tingling sensation and become numb after holding the wrist for a longer or even shorter period of time.
Problems are more pronounced at night – especially towards morning – than during the day. Shaking out the hands temporarily reduces the problem. The more the disease progresses, the worse the perception of touching with the fingers is. Finally, they become totally insensitive or deaf to the touch, the hand becomes weaker and more clumsy.
As long as the problems are mild and of a transient nature, it is possible to manage them by taking several breaks when doing work that is a burden on the wrist. When such problems persist, despite using this method, or if the situation becomes even worse, there are the options of immobilization, medication or surgery.
The operation is carried out under local anaesthesia. The nerve can be relaxed through a classic open or endoscopic method. The operation is short; it lasts from ten to fifteen minutes. The surgical procedure, followed by two months of rehabilitation, dramatically improves the situation.
Predisposition to the development of tough connective tissue in the hands and fingers, which eventually causes the fingers to curl, is a genetic condition.
The disease takes over the hand and fingers, usually in this order: the ring finger, little finger, middle finger, thumb and lastly, the index finger. The disease always begins with small, hard knots in the hands, which gradually spread to the direction of the ring finger or little finger and begins to resemble the subcutaneous connective strip.
The strip slowly contracts and the finger is pulled with it. Functionally, the hand becomes of less and less use, because the fingers cannot be straightened out. The means we cannot play musical instruments, shake hands, pick up larger items, reach into our pockets or put a pair of gloves on.
When the knot in your hand becomes annoying, or if the strip has pulled one or more fingers and the quality of your life has been reduced, it is time for you to visit us.
Treatment is primarily surgical. The procedure can usually be done on an outpatient basis under local or regional anaesthesia. During rehabilitation, which lasts 6 to 8 weeks, with exercises and splints or even through the operation, the gained flexibility of your fingers will be increased.
When only the hand and basic joints of the fingers are affected, the success of the operation is very good. The rule that earlier surgery is more effective than at late stages of the disease is true.
Do your fingers feel painful and get stuck in the morning, perhaps all day, or you have not been able to stretch them out for several weeks?
A trigger finger occurs when the motion of the tendon that opens and closes the finger is limited, causing the finger to lock or catch as the finger is extended. Sometimes the resistance to be overcome when the finger is extended is so great that the finger can only be extended with the help of the other hand or not at all.
The more the disease progresses, the more pronounced and painful the leap, which persists throughout the day. Frequently, many fingers are affected; in diabetics and those suffering with rheumatism, more fingers can be affected simultaneously.
A diagnosis can be set based on your problems and by observing and touching the nodes in your hand.
Treatment can be non-surgical or surgical. Mild, short-term difficulties can be eliminated by resting the finger on a support or with a special massage and pain medication.
The aim of surgical treatment is to cut the too narrow tendon clamp and release the tendon flow. It then heals, but it somewhat wider and this brings an end to problems due to constriction of the tunnel.
The dexterity of the finger is immediately corrected after the procedure. The improvement is often quite dramatic, especially if the finger had been practically immobile before.