Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by compression of the median nerve during the passage through the carpal tunnel in the wrist. Pain and paresthesia in the coverage area of ??the N. The main symptoms are median. The suspected diagnosis is made due to these symptoms and confirmed by the measurement of the nerve conduction velocity. For treatment include ergonomic improvements, pain control, splinting, sometimes corticosteroid injections or surgical intervention.

Carpal tunnel syndrome is very common and affects v. a. between 30 and 50 women. One of the main risk factors include a RA or other Handgelenkarthritiden also (the carpal tunnel of the Erstbefund can be here), diabetes mellitus, hypothyroidism, acromegaly, primary or dialysis related amyloidosis, as well as an induced by pregnancy edema in the carpal tunnel. Activities that require intensive and repeated flexion and extension of the wrist, rarely favor the occurrence. In most cases, carpal tunnel syndrome is idiopathic.

Carpal tunnel syndrome is caused by compression of the median nerve during the passage through the carpal tunnel in the wrist. Pain and paresthesia in the coverage area of ??the N. The main symptoms are median. The suspected diagnosis is made due to these symptoms and confirmed by the measurement of the nerve conduction velocity. For treatment include ergonomic improvements, pain control, splinting, sometimes corticosteroid injections or surgical intervention. Carpal tunnel syndrome is very common and affects v. a. between 30 and 50 women. One of the main risk factors include a RA or other Handgelenkarthritiden also (the carpal tunnel of the Erstbefund can be here), diabetes mellitus, hypothyroidism, acromegaly, primary or dialysis related amyloidosis, as well as an induced by pregnancy edema in the carpal tunnel. Activities that require intensive and repeated flexion and extension of the wrist, rarely favor the occurrence. In most cases, carpal tunnel syndrome is idiopathic. Symptoms and complaints pain in the hand and wrist in connection with tingling and numbness are traditionally located along the median nerve, v. a. palmar fingers in I to III and the radial side of the ring finger, but may affect the whole hand, in the extreme case. Typically, the patient wakes up at night with burning or piercing pain, tingling and numbness, shaking his hand a relief and a lessening of numbness is achieved. In the late stage a Thenaratrophie and weakness arise when gripping and abduction of the thumb. Diagnosis Clinical evaluation measurement of the nerve conduction velocity The diagnosis is confirmed by a positive Tinel’s sign, wherein the symptomatology is reproduced by pressure on the median nerve in the area of ??the carpal tunnel. The reproduction of the tingling in wrist flexion (Phalen sign) or by direct pressure on the nerve at the wrist in a neutral position (median nerve compression test) is also suspect. The median nerve compression test is positive if the symptoms develop within 30 seconds. but the distinction from other types of peripheral neuropathies can sometimes be difficult. For severe symptoms or uncertain diagnosis should be a measurement of nerve conduction in the affected arm to make the diagnosis and to rule out proximal neuropathy. Therapy splinting Occasionally, injection of corticosteroids / anesthetics Occasionally surgical decompression workplace improvements such as changes in computer keyboard, or other ergonomic adjustments can sometimes provide relief. Otherwise, the therapy involves the application of a slight wrist brace (s. Neutral wrist splint.), V. a. at night in combination with mild analgesics (eg. B. paracetamol or NSAID). In insufficient success, an attempt may with a combined injection of corticosteroid and anesthetic (eg., 1.5 ml of a solution of 4 mg / ml dexamethasone mixed with 1.5 ml 1% lidocaine) can be made in the carpal tunnel, the injection ulnar takes place next to the palmaris longus tendon and proximal to the distal wrist crease. If bothersome symptoms persist or come back, or if a weakness of the hand and a Thenaratrophie develop the carpal tunnel should be open or endoscopic surgery decompressed. Neutral wrist splint. Summary Although there are for carpal tunnel syndrome many risk factors, most cases are idiopathic. Typical symptoms include pain in the wrist and hand along with tingling and numbness along the palmar side of the thumb, the index and middle fingers and the radial half of the ring finger. A reproduction of the symptoms by flexing the wrist or by pressure on the median nerve can provide useful diagnostic clues. The treatment consists first in ergonomic adjustments, then in an attempt to splinting and analgesics, Kortikosteroidinjektion and weakness, muscle wasting and / or severe refractory symptoms in surgical decompression.

Health Life Media Team

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