Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve at the wrist becomes compressed, making it the most common cause of hand numbness due to nerve entrapment.
The term itself is quite literal: Carpus means “wrist” in Latin, while the carpal tunnel refers to the narrow passageway in the wrist where the median nerve runs alongside several tendons that bend the fingers. When the wrist is used repetitively or held in the same position for long periods, the median nerve can be squeezed against the tunnel’s roof—called the transverse carpal ligament—causing numbness, tingling, or pain. Symptoms typically affect the thumb, index finger, middle finger, and part of the ring finger.
Risk Factors
Carpal tunnel syndrome is often linked to everyday habits and occupations that keep the wrist bent or extended for prolonged periods. Common activities include:
- Using a mobile phone or tablet for long hours
- Driving
- Typing or computer work
These positions can increase pressure on the median nerve. In addition, repetitive hand movements may cause inflammation and swelling of the tendon sheaths inside the tunnel, indirectly compressing the nerve.
Treatment Options
Initial treatment often begins with:
- Rest and activity modification
- Physical therapy or wrist splints
- Anti-inflammatory medication (oral or local injection)
If symptoms persist or worsen, surgical intervention may be required for long-term relief. Surgery involves cutting the transverse carpal ligament to enlarge the tunnel and reduce pressure on the nerve.
Surgical Techniques
1. Open Release Surgery
- A 2–3 cm incision is made in the palm.
- This long-established method offers reliable outcomes.
- Challenges include post-operative care since the palm is frequently exposed to touch and water.
- Scarring in the palm area may cause ongoing tenderness or discomfort.
2. Endoscopic Release Surgery
- A minimally invasive approach using a small 7–8 mm incision at the wrist rather than the palm.
- Allows patients to return to daily activities more quickly.
- Minimizes palm scar pain.
- Safely and effectively releases the ligament along the entire tunnel length.
“Surgery can be compared to wearing a belt that has become too tight after weight gain. Eventually, the pressure becomes uncomfortable. By enlarging the belt hole, the tightness is relieved, and comfort is restored.”
