Carpal tunnel syndrome (CTS) is a condition caused by injury or stimulation of the median nerve as it passes through a part of the wrist called a carpal tunnel.
The tunnel is formed by a roof consisting of eight wrist bone floors and a strong fibrous tissue called the flexor retina.
CTS is the most commonly diagnosed and treated capture neuropathy (pinched nerve condition) and affects millions of Americans.
When the nerve is exposed to pressure, the swelling progresses, progressive symptoms that can be debilitated occur and prevent individuals from engaging in hobbies and work activities.
An estimated 8 to 10 million people in the United States suffer from carpal tunnel syndrome.
Approximately half of the cases affect both wrists. Women have a rough advantage of 4 to 1 and peak at the age of 50.
Carpal tunnel syndrome is caused by compression of the median nerve caused by pressure increase inside the carpal tunnel. Various causes have been identified and pressure is rising. These include fractures, beating of arthritis, inflammation of the inner layer of the joint from arthritis, infection, gout, diabetes, hypothyroidism, pregnancy, alcoholism, and renal failure.
A typical symptom that patients complain is that they are falling asleep or weak. Nocturnal symptoms and relief with hand swaying also refer to Carpal Tunnel Syndrome. Paralysis and pain typically affect parts of the thumb, forefinger, middle finger and ring finger.
Atrophy of thick muscles just under the thumb is late discovery. The patient may appeal to a firm emotion or sense of temperature change in the hand.
Numerous physical examination tests have been proposed. (Trembling with complete wrist flexing to bend the wrist), central nerve compression test (reproduce symptoms with firm pressure on the carpal tunnel)).
Electrical examination by measurement of nerve conduction is useful for confirming diagnosis of carpal tunnel syndrome and accuracy is 85% to 90%.
Imaging testing can also help diagnosis. Using high-definition ultrasound, the median nerve and tendon can be evaluated non-invasively. Compared with magnetic resonance imaging (MRI), ultrasound is faster and cheaper. It can be used to evaluate blood flow and provide images while the patient is asked to bend and straighten the wrist.
A good correlation between ultrasonic measurement of the median nerve and electrical examination has been demonstrated.
MRI is the most sensitive and specific test for detecting carpal tunnel syndrome. It provides an excellent appearance of soft tissue structure.
For most patients, initial treatment is nonsurgical and surgery is reserved for those with signs of nerve injury. Steroid injection, splints, and anti-inflammatory drugs may be useful.
Flexion of the wrist helps limit the symptoms by preventing particularly useful wrist flexion during the night. These are mainly used for patients with mild symptoms.
Opening of the carpal canal can be done as an open procedure or via a small telescope.
A new approach to injecting fluid using a small needle and releasing the median nerve by piercing the flexor retina has been shown to be very effective for approximately 80% of patients with carpal tunnel syndrome, and the need for surgery You can prevent sex. (Clark T, Malone D, Wei N., American College of Rheumatology, Philadelphia, announced in October 2009).
