Carpal Tunnel Syndrome: What is it and how is managed?
- katerinavr9
- Jan 11
- 2 min read
Introduction
Do you suffer from pain, numbness, tingling in your fingers, or even a burning sensation? Do the symptoms worsen at night or while driving? You may have carpal tunnel syndrome, a common condition that mainly affects women but also people who perform repetitive hand movements or heavy manual labour.
Neurosurgeon Dr Mazarakis can assess you appropriately and direct you towards the right treatment.
What is the Carpal Tunnel
The carpal tunnel resembles a tunnel in the wrist, formed by bones below and a tough ligament above. It contains tendons for finger movement and the median nerve, which controls sensation and strength in the thumb, index, middle, and ring fingers. When the nerve is compressed there, symptoms appear.
Symptoms
Numbness or tingling in the fingers, particularly at night or after repetitive movements.
Pain extending towards the thumb or forearm, often with a burning sensation.
Weak grip, e.g. difficulty holding a glass, and in advanced stages, muscle atrophy in the palm.
Causes and Risk Factors
It is caused by swelling in the tendons or narrowing of the tunnel, often from repetitive movements, pregnancy, diabetes, rheumatoid arthritis, or thyroid problems. Other factors include obesity, wrist injuries, or a hereditary tendency for a narrow tunnel.
Diagnosis
Diagnosis of carpal tunnel syndrome begins with a careful history and clinical examination by the specialist, focusing on symptoms such as numbness and pain in the fingers. It is confirmed with specialised tests and laboratory investigations for an accurate assessment of severity.
Clinical Examination
The doctor applies specific tests to provoke the symptoms and identify pressure on the median nerve.
Tinel's Test: Tapping lightly over the wrist; if you feel an electric shooting sensation in the fingers (thumb, index, middle), it is positive.
Phalen's test: Flexion of the wrists back-to-back for 30-60 seconds reproduces numbness if condition is present.
Durkan's test: Direct pressure on the carpal tunnel for 30 seconds, the most sensitive test, reproduces numbness or pain in the median nerve distribution.
Laboratory Tests
Electromyography (EMG) studies with nerve conduction, confirm the diagnosis and rule out other conditions, although it sometimes shows no changes in mild stages.
X-rays rule out bony problems, whilst ultrasound or magnetic resonance imaging can reveal tendon swelling.
Treatment
Initially, a night splint, ice therapy, anti-inflammatory drugs, or cortisone injections are trialled to reduce pressure. If symptoms do not improve within 3-6 months, surgical nerve release is recommended via a small incision, endoscopically or openly, with rapid recovery (return to work in 1-2 weeks).
Neurosurgeon Dr Mazarakis has significant experience in the surgical management of carpal tunnel syndrome.
Recommended Post-Operative Exercises
Some exercises recommended for post-operative rehabilitation:
For further information please call at 00306975400064 or contact through our email.
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