The carpal tunnel syndrome is trauma caused by the repetitive motion of the fingers, damaging the median nerve which is at the height of the wrist.
The anatomy of the hand consists from the wrist to the base of the big finger. Between them, there is a space which is called the carpal tunnel, a bridge whose roof is formed by the carpal ligament, and where finger flexor tendons and the median nerve are. The tunnel space is occupied by these structures. When they are used in excess, the tendons become inflamed and therefore take up more space. As there isn’t space to fit because of the rigid structures and bones at the top of the carpus, the pressure goes to the structure of the median nerve and it is compressed, causing the classic symptoms of Carpal Tunnel Syndrome, with numbness in the middle finger, index and ring, intermittent pain, weakness and sometimes paralysis; these symptoms are worse at night and can cause stiffness in the morning.
Women, the most affected
Carpal tunnel syndrome is very common among people who have jobs that require taking things constantly bending the wrist or finger flexion. People at risk include those who use computers, carpenters, grocery checkers, meat packers, musicians and mechanics. Activities such as gardening, needlework, golfing and canoeing can sometimes cause this condition.
It is more common in women than in men between 40 and 60 years, in a ratio of 4:1 to 9:1, because they have higher water retention and the type of activity performed.
- This condition causes paresthesias (numbness and tingling in the fingers, especially the big, index and middle).
- Presence of pain that sometimes radiates to the forearm and often wakes the patient at night. 40 percent of cases are associated with pain in the elbow and shoulder.
- Symptoms occur when performing activities like driving, writing, using the computer keyboard or other exercises that involve significant use of the hand.
- In severe cases, the muscles of the base of the thumb can weaken or atrophy.
- Problems in the function of the fingers, which often reduce the capacity and tightening or clamping force of an object.
Put your hands together as if you were praying and open and raise the elbows to detect if there is pain or numbness.
A test called "tinnef sign" which consists in tapping the finger to the wrist, especially in the region of the tunnel Carpio, which can produce a sensation of electric shock, indicating that the syndrome exists.
The diagnostic test called electromyography assesses the condition of the nerves that control the muscles and detects very precisely the degree of compression of the muscles.
Depending on the severity, it can be conservative or surgical. If detection is early, the treatment will be the first one. If this does not work and the patient continues with symptoms, he/she should resort to surgery.
There is no way to prevent this condition. Once symptoms occur, the important thing is address it as soon as possible to avoid ending up in surgery. If the keyboard is used a lot, or many fingers are flexed with constant activity, it should be neutral. If you change the activities and try to find the best position, the chances of the syndrome progressing are low.
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