DR. MED. KALVIS PASTARS
Dr. med. Kalvis Pastars Head of the Latvian Microsurgery Center, certified plastic surgeon, microsurgeon, hand surgeon.
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Carpal tunnel syndrome is a neurological disorder in which tissues in the carpal tunnel of the wrist become swollen and compress the median nerve. The carpal tunnel is a narrow tunnel through which the median nerve and tendons of the fingers pass in the hand.
Over the course of a lifetime, the tendons and ligaments in the wrist thicken, and the nerve may be gradually compressed. The problem is more often faced by people whose work is associated with heavy loads on their hands. Tunnel syndrome occurs 4 times more often in women than in men.
Symptoms of the disease: progressive tingling and pain in the hands, especially at night, and swelling, accompanied by numbness of the fingers in the morning. Most often, the leading hand gets sick first.
Ignoring symptoms can lead to movement problems, weakness in the hands, and an inability to pick up and hold small objects. In such cases, surgery is necessary.
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If during the day the hands are numb and swollen, and at night they hurt, this is most likely carpal tunnel syndrome. This is one of the most common occupational diseases affecting people who do daily work with their hands.
When passing through the natural narrowing of the body or tunnels, as a result of various pathological processes, the nerves can be pinched, which significantly impairs the function of the hand. The most common symptoms of carpal tunnel syndrome: pain in the hands, burning, numbness of the hands and fingers (especially at night). The carpal canal (tunnel) is located at the base of the palm, through which the flexor tendons and the median nerve pass. It provides sensitivity for the thumb, index, middle and ring fingers.
The most common causes of carpal tunnel syndrome are:
There is a feeling of numbness of the fingers, pain and dysfunction of the palms due to muscle wear. Carpal tunnel syndrome is more common in women with diabetes and in people with an underactive thyroid. Often, in patients with complaints about the carpal canal, damage is also found in other canals, up to the roots of the spinal cord.
Initially, anti-inflammatory medications, splints, and median nerve stretching may help with carpal syndrome. Steroids can also be injected into the carpal canal.
If all of the above treatments fail, then surgery is required. An endoscopic or conventional operation can be performed.
During the operation, a small incision is made at the base of the hand under direct visual control. The second option: separation of the ligament by endoscopic method to reduce pressure in the carpal tunnel.
Currently, conventional operations are preferred in the world.
The duration of the operation is on average half an hour. The operation is performed under local or general anesthesia. Treatment takes place on an outpatient basis.
After the operation, local discomfort and pain are felt, which are well controlled by painkillers. The wound heals on average within 2 weeks. The patient needs to be dressed 2-3 times a week. After two weeks, the sutures on the skin are removed. Ergotherapy and the development of finger and palm movements are also required in the postoperative period.
As a result, pain at night is significantly reduced or disappears altogether. However, the outcome of the operation depends on how long the nerve has been pinched. If there is pain and numbness in the fingers that does not go away within a few days, it is important to see a doctor in a timely manner. Disability lasts an average of 6-8 weeks.
How surgery is performed
Duration of the surgery
An average of 0.5 hours.
Anesthesia
Local or general
Treatment
Outpatient
After surgery
Recovery
It is expected that there will be local discomfort and pain after the operation, which is well controlled with painkillers.
The wound heals in an average of 2 weeks. The patient needs to change dressings 2-3 times a week. After two weeks, the skin sutures are removed. At the same time, in the post-surgery period, occupational therapy and the development of movements in the fingers and wrists are required.
Result
The pain at night is significantly reduced or even eliminated. However, the results of the surgery depend on how long the nerve has been compressed. It is important to see a physician early if you experience pain and tingling in your fingers that does not go away for several days. Incapacity for work lasts on average 6-8 weeks.
Can carpal tunnel syndrome be transmitted without surgery?
Studies show that 50% of patients with primary carpal tunnel syndrome have complaints that persist within a year and do not recur during their lifetime. The worse prognosis is when only one hand tingles, as this may be a symptom of other diseases, such as diabetes or thyroid disease. In the case of carpal tunnel syndrome, physiotherapy, nocturnal palm rest, and steroid injections may help.
Is steroid injection (blockage) harmful?
A single steroid injection does not cause the side effects of steroid use, but can significantly reduce or eliminate finger pain and tingling. However, repeated injections into the carpal tunnel should be avoided. In diabetic patients, the injection may cause a temporary rise in glucose levels.
Will the numbness in the fingers disappear after the operation?
If the nerve has not developed axonal damage or oversized nerve fibers from prolonged compression, the numbness disappears and almost never returns. If the numbness before surgery is constant, the muscles in the palm are worn out, it may take more than a year for the sensation to return. It depends on the growth of scar tissue in place of the damaged fibers. Therefore, the operation should be performed before the permanent numbness of the fingers.
How long will I not be able to work after carpal tunnel surgery?
From the next day, you have to start developing movement in your fingers, after 2-3 days with the operated hand you can start doing small tasks such as holding a spoon. If you are an office worker and do not have to burden your hand, you can return to work in 3-4 weeks. However, hard physical workers have to rest for 2-3 months until the wrist regains its ability to work.
Carpal tunnel syndrome
470 €
The price of the operation includes surgery, anesthesia, hospital stay, and the costs of subsequent recovery processes.
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