Carpal tunnel syndrome: Information & recommended doctors

22.11.2023
Leading Medicine Guide Editors
Author
Leading Medicine Guide Editors

Carpal tunnel syndrome is a common cause of pain in the arms and hands. It is the compression of a nerve, which if left untreated can lead to severe problems – including motoric problems – as well as pain.

Here you will find further information and selected doctors for the treatment of carpal tunnel syndrome.

ICD codes for this diseases: G56.0

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Brief overview:

  • What is carpal tunnel syndrome? If the nerve that runs from the shoulder into the upper and lower arm is squeezed in the wrist area, this is known as carpal tunnel syndrome.
  • Causes: Wrist injuries, excessive stress, thyroid problems and hormonal imbalances, as well as pre-existing conditions such as diabetes, renal insufficiency, rheumatism
  • Symptoms: Hands becoming numb, tingling in the hands or arms that spreads over time, pain and swelling, muscle wasting, paralysis.
  • Treatment: The underlying cause must be treated. In the early stages, conservative therapy (immobilisation, medication) can also achieve good results. Carpal tunnel surgery is recommended for severe symptoms.
  • Experts: Specialists in the fields of hand surgery and neurosurgery are the right people to contact.

Article overview

What is carpal tunnel syndrome?

Carpal tunnel syndrome is the compression of the median nerve, which is found in the wrist area. This nerve runs from the shoulder into the upper and lower arm.

The carpal tunnel is located on the inside of the wrist. The nervus medianus and various ligaments and tendons run through this tunnel.

Carpal tunnel syndrome is relatively common and often occurs on both sides. Children are rarely affected, but it is more common in people between 40 and 70 years of age. Statistically, women are affected more often than men.

What are the causes of carpal tunnel syndrome?

The causes of carpal tunnel syndrome can be varied. Injuries near the wrist are often the cause.

Other risk factors are

Increased water retention in the joints as well as a thickening of the ligament structure can also promote carpal tunnel syndrome. Also those who suffer from renal insufficiency and need dialysis are at greater risk. Often the carpal tunnel syndrome then occurs on the side on which the shunt sits.

Physical strain also plays a role. Certain occupational groups are more frequently affected. This includes road construction workers who have to operate a jackhammer, for example. The risk of developing carpal tunnel syndrome increases with regular heavy use of the wrists.

Karpaltunnelsyndrom
Illustration of the anatomy involved in carpal tunnel syndrome © Henrie | AdobeStock

What are the symptoms of carpal tunnel syndrome?

The symptoms can be very diverse. Unfortunately, many of those affected do not take the first signs seriously.

In the early stages, the hands may become numb, even at night. In addition, there is often a tingling sensation in the hands or arms. This sensation often starts in a single finger and then spreads further and further. The tingling sensation can also be accompanied by pain and swelling. The ability to touch and the sense of touch can also suffer.

If those affected ignore these signs, more severe damage is inevitable. In extreme cases, paralysis may even occur.

In the advanced stage, muscle wasting also occurs. The thumb is particularly affected by this, as it is directly connected to the damaged nerve. The muscle loss leads to the sufferer being severely limited as gripping strength can suffer.

Basically, however, very different symptoms can occur. The damage on the other side of the body may also not show up until much later.

Every now and then, the symptoms may improve on their own. However, the basic problem, the constriction of the nerve, still exists.

The attending doctor will perform a carpal tunnel syndrome test to get a more accurate picture of the symptoms.

The following symptoms can occur with carpal tunnel syndrome:

  • Tingling in fingers and hands
  • Pain
  • Swellings
  • Muscle loss and reduced grip strength
  • Signs of paralysis

How is carpal tunnel syndrome treated?

Treatment depends on the stage of the carpal tunnel syndrome. If the symptoms have not progressed too far, conservative therapy is usually used.

The treatment focuses on the therapy of the underlying disease. For example, if diabetes is the cause of carpal tunnel syndrome, the diabetes must be treated.

To relieve the acute pain, measures such as immobilisation of the affected arm or medication are used at the same time.

If excessive stress is the cause of carpal tunnel syndrome, the arm should be rested. This allows nerves and other structures to recover. At the same time, anti-inflammatory drugs or cortisone injections can provide relief.

Carpal tunnel surgery is recommended in advanced stages or in cases of severe symptoms. The operation can be either performed open or arthroscopically. The advantage of minimally invasive treatment is that the patient can move his or her hand earlier.

Surgery usually involves cutting the carpal ligament, which lies over the bone groove at the wrist. The surgeon also removes tissue that can constrict the nerve. This relieves the pressure on the nerve.

After the operation, the patient must rest the arm for several weeks. Sport or work leave depends on the healing process and the stress to which the hand is exposed in professional or sporting life.

Who treats carpal tunnel syndrome?

In case of carpal tunnel syndrome, it is advisable to consult a specialist. An expert in the field of hand surgery is the first port of call here. However, since carpal tunnel syndrome also involves nerves, a specialist in neurosurgery is also required here.

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