Carpal tunnel syndrome: numb and sore hands
Everyone knows the tingling sensation or the numbness when hands or feet fall asleep. As soon as you move, this feeling usually disappears quickly. If you experience symptoms like this in your hands more often, you may have carpal tunnel syndrome: an entrapment of the metacarpal nerve in the wrist tunnel.
In carpal tunnel syndrome, there is chronic pressure damage to the median nerve that runs along the wrist and controls the movements of the fingers and thumb, among other things. This is due to a narrowing of the carpal tunnel, which occurs in families. “Women are about three times more likely to be affected than men. Patients who suffer from the syndrome initially usually experience symptoms such as hands falling asleep or numb fingers - initially mainly at night or towards morning. In the course of the day, the symptoms mentioned, abnormal sensations in the thumb to middle finger and later also pain also occur during the day, for example when making calls or cycling, ”reports Dr. Mohamed Arafkas, specialist in plastic and aesthetic surgery as well as hand surgery and chief physician at the Petrus Hospital in Wuppertal, Clinic Association St. Antonius and St. Josef. Over time, there could also be a decrease in the sense of touch, signs of paralysis and muscle wasting on the ball of the thumb.
If those affected suffer from the symptoms mentioned, they should consult a doctor. If carpal tunnel syndrome is detected early, it can often be treated without surgery. “If there is a suspicion, doctors do an examination of the electrical conductivity of the nerves, or NLG for short, to confirm the diagnosis. To do this, short electrical stimuli are sent through the arm via electrodes. With a healthy nerve, the muscles in the hand respond. If the conductivity is disturbed, however, this indicates the carpal tunnel syndrome. The subsequent treatment depends on the extent of the symptoms and depends on the duration of the symptoms, ”explains the specialist. In the early stages, the syndrome can often be treated by wearing a wrist splint that is put on at night. Sometimes cortisone, which is injected into the carpal tunnel and has a decongestant and anti-inflammatory effect, also helps.
If the treatments mentioned are not sufficient or if the paresthesia and pain persist, an operation will be necessary. The operation is usually carried out on an outpatient basis and under local anesthesia of the affected arm. Surgeons cut the carpal ligament over the carpal tunnel through a small incision in the palm of the hand, which gives the nerve more space. As a rule, the symptoms disappear and the hand function normalizes with physiotherapeutic exercises afterwards.
However, many patients only turn to a doctor when there is already severe damage to the nerve with constant numbness: “Even at this very advanced stage, surgeons can still perform the operation, but certain functions cannot always be restored,” says Dr. Arafkas. An early diagnosis and treatment increase the chances of recovery immensely.