The syndrome that prefers women
About it, its causes, diagnosis and available treatments
Carpal tunnel syndrome is one of the most common compressive neuropathies of the upper limbs and about 95% of all entrapment neuropathies as well as the most common type of disease from repetitive trauma. It is thought to be caused by compression of the median nerve at some point in its passage through the carpal tunnel.
The median nerve is formed by the fusion of the external and internal cords of the brachial plexus and carries fibres, both motor and sensory.
The motor fibres innervate all the muscles of the anterior surface of the forearm, except the ulnar flexor of the wrist and the ulnar half of the deep flexor of the fingers.
The sensory fibres of the median nerve innervate the palmar surface of the first three and a half fingers (thumb, index, middle and radial half of the lateral half of the thumb).
What is the cause of carpal tunnel syndrome?
The causes that can cause carpal tunnel syndrome vary:
Narrow tube: There are patients, who have congenital narrow carpal tunnel
Chronic hand strain: People with manual occupations are affected 3-7 times more often
Injuries: Fracture of the peripheral radius can cause carpal tunnel syndrome
Inflammation: Tendinopathies in the 9 tendons surrounding the nerve can put pressure on the nerve
Autoimmune Rheumatic Diseases
Rheumatoid arthritis: Inflammation of the joint's bursa or tendon sheath, which occurs in
Rheumatoid arthritis patients can cause the syndrome
Kidney failure: Patients undergoing dialysis more often present with carpal tunnel syndrome
tube
Metabolic diseases-disorders: Conditions such as diabetes, hyperthyroidism, hypothyroidism, obesity
Diabetes, hyperthyroidism, obesity and pregnancy for women are associated with a high probability of
developing the syndrome.
The disease mainly affects women and less so in men.
How does carpal tunnel syndrome manifest itself?
The predominant symptom of carpal tunnel syndrome is intermittent numbness of the thumb, index, middle and half (radial) fingers of the ring finger, i.e. the areas innervated by the median nerve, while the little finger is rarely affected, as it is innervated by the ulnar nerve. In some cases, however, all the fingers may be affected if the ulnar nerve is affected at the same time.
The numbness typically occurs usually at night.
Diagnosis
The diagnosis of the disease is made by good clinical examination. It is essential to exclude various conditions that resemble carpal tunnel syndrome because:
1. Carpal tunnel syndrome may be the first manifestation of a rheumatic or other disease or may be part of the manifestations of an already known or unknown rheumatic disease.
2. The patient may not have carpal tunnel syndrome, but another condition similar to it, e.g. the numbness of the hands may be caused by pressure on other nerves, such as radiculopathy (i.e. compression of the nerve roots by a herniated disc or herniated cervical disc).
3. The swelling (subjective) that causes carpal tunnel syndrome in the hands is attributed to rheumatoid arthritis or other rheumatic diseases and is referred to a rheumatologist.
4. The patient, in addition to the familiar numbness, may have pain in the wrist area, which is attributed to arthritis from rheumatic disease.
Treatment
It depends on whether the carpal tunnel syndrome is primary or secondary. If it is due to an underlying disease, treatment is required.
In conclusion
Once carpal tunnel syndrome is diagnosed, surgery should not be performed immediately, but a full history should be taken to establish or exclude the presence of a disease that may be causing the syndrome.
Carpal tunnel syndrome may be the first manifestation of an autoimmune rheumatic or other disease or may be part of the manifestations of an already known or unknown rheumatic disease.