Carpal tunnel syndrome
What is carpal tunnel syndrome?
The carpal tunnel is situated between the two flexion folds of the wrist. It is formed on the bottom by the wrist bones and on the top by a ligament (the anterior annular ligament of the wrist).
Inside this tunnel pass the flexor tendons of the hand and the medial nerve, responsible for the sensitivity and strength of the thumb, the index and the middle fingers.
Carpal tunnel syndrome corresponds to the compression of the medial nerve.
The internal pressure of the carpal tunnel can increase because of trauma (the sequelae of a fracture) or for reasons that are either hormonal (hormonal change such as menopause or pregnancy) or mechanical (repeated movements). The first three fingers go numb, there is a pins-and-needles sensation and then the pain (often at night) appears.
Carpal tunnel syndrome is part of what is known as musculoskeletal disorders. It is common and more often than not affects women over the age of 50.
Orthopaedic management can fit into the framework of a medical treatment prescribed by your doctor. In case of doubt, ask your doctor or orthopaedist for advice.
Orthopaedic treatment
In many cases, carpal tunnel syndrome disappears spontaneously after 2 years. During this period, night-time rest with a rigid splint produces good results in 70 % of cases: the combined effects of not being able to bend the wrist and the muscle balancing decrease the pressure inside the carpal tunnel.
The person no longer has the pins-and-needles sensation and the pain decreases both during the day and at night.
If the orthopaedic treatment fails, in cases of post-traumatic conditions or micro-traumas caused by repeated movements, surgery is recommended.
If the carpal tunnel syndrome is not treated, the paresthesia (pins-and-needles, burning sensations) becomes accompanied by paresia (a decrease in force in the thumb's pincer movement) and can even result in paralysis where it is impossible to write or hold everyday objects such as a knife or fork. In all cases, do not hesitate to contact your doctor.
