Carpal tunnel syndrome?

Carpal tunnel syndrome is a common source of hand numbness and pain. The tendons in the wrist swell and put pressure on the median nerve, one of three major nerves responsible for supplying feeling in the hand. It is more common in women than men and affects up to 10 percent of the entire population.

CARPAL TUNNEL SYNDROME………
^in this the median nerve suppling the fingers is compressed by the flexor retinaculum in the wrist.
^mainly seen in boxers
^there is flattening of the thenar eminence;loss of sensation in the lateral 31\2 fingers(thumb index and middle and half of ring finger);partial clawing of index and ring finger due to paralysis of 1st and 2nd lumbrical muscles;there is oedema,pigmentation and dryness of skin nailbeds become friable over lateral 3\12 fingers.
^surgery is the permanent cure for it

Hello,

I don’t know if I can manage an essay quite that long, but the ‘carpal tunnel’ is a tunnel under the front of each wrist, formed on top by a tough fibre band which bridges the gap between two opposite wrist (= carpal) bones.

Through this tunnel pass the long tendons which connect the fronts of the fingers up to the muscles in the forearm, which actually work to flex them into a fist.

Also through this tunnel passes a nerve called the ‘Median’ nerve, which carries sensation to the thumb and index, middle and half the ring finger, and also carries power to some of the thumb muscles.

The carpal tunnel has only so much space in it: the things running through it, are quite a tight fit. If for any reason the pressure within the carpal tunnel rises, then it presses on the Median nerve and prevents it from working properly.

The symptoms are that the person feels pain especially at night, in the parts of the hand that the Median nerve supplies, that is to say, pain in the thumb, index, middle and half the ring fingers on the palm side of the hand.

Pain is the main symptom, but over time there may be shrinkage of some of the power muscles of the thumb, which the Median nerve also supplies.

People who use their hands to form fists a lot, may get a rise in pressure within the carpal tunnel, from all the long tendons sliding backwards and forwards so much. Some illnesses are associated with carpal tunnel syndrome, for example low thyroid hormone problems, (myxoedema).

Clearly if there is a low thyroid problem, you treat that. For most cases, you can have a small injection of cortisone (steroid) into the carpal tunnel at the front of the wrist, this works by relieving inflammation in the tunnel. For really bad or resistant cases, you can have the tunnel ‘de-roofed’ by cutting the fibre band which forms the roof of the tunnel. This relieves the pressure inside and the Median nerve recovers.

It’s an uncommon problem.

Hope this is of some help.

Best wishes, Belliger (retired uk gp)