Carpal tunnel syndrome, the main symptom of which is tingling in the hand, affects women more. Some professions are also more exposed.
Carpal tunnel syndrome is a common condition characterized by compression of the median nerve of the wrist. This syndrome particularly affects women around menopausereports Public health France, and people who work in jobs requiring a lot of hands, in strength, and in a repetitive way. In France, it is the second pathology recognized as an occupational disease (after rotator cuff pathologies).
What is the definition of carpal tunnel syndrome?
Carpal tunnel syndrome is a so-called tunnel syndrome that characterized by compression of the median nerve of the wrist. “This nerve is mixed : he is sensitive for the first 3 fingers of the hand (thumb, index and middle finger) and half of the ring finger), it is also engine (it brings a current from the brain to the fingers to control the muscles at the base of the thumb called the thenar muscles). Of the same way as a garden hose water vehicle, a nerve is a pipe that carries electricity. Carpal tunnel syndrome is like a stone that would have been placed on this pipewhich causes a drop in electricity flow“, illustrates Dr. Charles Schlur, upper limb surgeon.
What causes carpal tunnel syndrome?
Carpal tunnel syndrome is caused by compression of a nerve. It particularly affects women during a period of hormonal change, for example around pregnancy (during/after) or menopause (around age 50), or hard workers who make repeated gestures: it enters into this case in the category of professional diseases. “We can also see carpal tunnel syndromes secondary to a wrist fracture, osteoarthritis or at very local trauma“, continues our interlocutor.
What are the typical symptoms of carpal tunnel syndrome?
Symptoms of carpal tunnel syndrome vary widely from person to person, but more frequent are tingling of the hand (paresthesia) that occur usually at night (often in the second part of the night) which forces you to wake up and have to shake your hand. These tinglings are sore and may radiate to the elbow or be accompanied byloss of strength in the hand clumsiness in everyday gestures or a loss of hand muscles at the base of the thumb for more advanced forms.
Is carpal tunnel syndrome unilateral or bilateral?
“When it is due to hormonal change, carpal tunnel syndrome is often bilateral : both hands are affected even if one of the two hands is often more affected than the other“, answers our expert. Carpal tunnel syndrome secondary to trauma is unilateral.
The diagnosis is based on a physical examination because the symptomatology is very evocative. The doctor makes sure that it is indeed a carpal tunnel syndrome and checks that there is no cervical nerve compression or at the level of the plexus for example. Most often, the doctor prescribes an electromyogram, a complementary test that calculates the flow of electricity in the nerve. “This examination allows not only to confirm the presence of a carpal tunnel syndrome but also to quantify it and to have a prognosis on the recovery. Other examinations (x-rays) can be carried out if secondary causes are suspected, such as a fracture of the wrist, for example.“, says Dr. Schlur.
What treatment to treat carpal tunnel syndrome?
Once the diagnosis has been made and depending on the symptomatology and the context of the onset of the carpal tunnel syndrome, we set up a treatment who can be :
► medical : wearing a brace at night in order to rest the wrist and corticosteroid infiltration when possible and the carpal tunnel is not too severe. “The infiltration is carried out by the radiologist, the rheumatologist or the surgeon and it is rather practical when it comes to carpal tunnel syndrome transient, for example, in the event of pregnancy. On the other hand, infiltrations in a postmenopausal woman (menopause being an irreversible hormonal state) are not the most appropriate solutions.“, explains Dr. Charles Schlur.
► surgical: “it is an extremely frequent intervention (the second most frequent surgery in France behind cataract surgery) benign, fast (you can move your fingers immediately after the intervention) and effective which is done on an outpatient basis in the vast majority of cases under endoscopy (by making an incision of less than about 1 cm, at the wrist) And under loco-regional anesthesia. If the intervention is carried out well, there is almost no no risk of recurrence and this prevents aggravation towards paralysis of the hand. Complications of the intervention are rare or even anecdotal“, concludes the surgeon. The disappearance of night pain is instantaneous. On the other hand, we can keep a slight lack of strength and pain when pressing on the palm of the hand for 2 to 3 months.
Thanks to Dr. Charles Schlurupper limb surgeon in Paris & Neuilly-sur-Seine.