Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome – the disease is based on tendovaginitis of the flexors of the fingers or stenotic ligamentitis of the transverse palmar ligament of the wrist. This syndrome is less common than ligamentitis of the dorsal ligament, as flexors have stronger tendons than extensors.

The essence of the disease is the development in the canal of a pathological process (inflammatory, traumatic, tumor character) that increases the intracanal pressure, which results in (pressure of the branch of the median nerve passing here. As a rule, acidic flexor tendons are included in the pathological process with their thickening and the formation of stenosing tenosynovitis, and the transverse ligament itself, where fibrotic changes develop (stenosing ligamentitis), all of which lead to iju branch of the median nerve against the transverse ligament, resulting in the occurrence of sharp pain in the wrist.

Causes of Carpal Tunnel Syndrome

The causes of carpal tunnel syndrome are primarily injuries of this area, inflammatory diseases of the wrist joint and surrounding tissues, the development of neuromas, ganglia and other pathological formations, as well as circulatory disorders – venous congestion, vasomotor and humoral disorders that cause ischemia of the median nerve branch.

Symptoms of Carpal Tunnel Syndrome

Sharp, burning pains in the I-III fingers of the hand and the radial side of the IV finger, aggravating at night and causing insomnia, decreased sensitivity of the fingertips, hand strength, skin changes in the three fingers (acrocyanosis or pallor) and a number of trophic disorders in the innervation of the median nerve (diffuse swelling of the fingers and hands, increased sweating in this area, erasure of the skin pattern, muscle atrophy), in severe cases – the formation of trophic ulcers at the fingertips.

On examination, you can find limited swelling and soreness on the palmar surface of the wrist joint (especially in its radial part). Pain in this area is aggravated by flexion and extension of the hand, as well as when the shoulder is compressed by the cuff of the tonometer for 2 minutes (symptom of the cuff) or when raising the arm. Atrophy of tenor muscles and a decrease in hand strength with dynamometry are observed. When x-ray abnormalities are not detected. The course of carpal tunnel syndrome in traumatic injury can be acute or prolonged, chronic. In these cases, after a short rest of the affected limb, all symptoms quickly disappear, with severe course persistent contractures of the hand and fingers may develop.

Diagnosis of Carpal Tunnel Syndrome

For diagnosis, the characteristic localization of trophic changes only in the radial half of the palm is important, and this disease differs in the Guyon channel, the truncitendovaginitis of the back ligament has a similar clinical picture with the syndrome.