Even everyday things, such as shaking hands, become torture with carpal tunnel syndrome. Image: Tobias Wolter, Wikipedia (cc-by-sa2.5 license)
The carpal tunnel syndrome is something of a common disease. A pinched nerve in the middle hand causes tingling fingers and numbness. Pain severely limits those involved in everyday activities such as driving or phoning. However, an operation usually brings a quick remedy: the pain disappears after a few days. However, the instinct returns only after a few weeks to months. First, it is only a slight tingling in the fingers, which occurs especially at night. Later, numbness is added, the fingers swell and especially thumb, index and middle fingers lose strength. Every movement hurts, and everyday activities such as phoning, cycling and driving or gardening become torture.

Such or similar complaints are typical signs of the so-called carpal tunnel syndrome. It's almost a common disease. "According to a study from southern Sweden, about 15 percent of adults suffer from the typical symptoms of carpal tunnel syndrome, " reports Martin Jung, a doctor at the Heidelberg University Orthopedic Clinic. At least five percent of the population is proven to be proven. And the number of new cases is relatively high with 3.5 people affected per 1, 000 inhabitants and year. In the process, women in particular fall ill between the ages of forty and seventy. Other risk groups are pregnant women and rheumatics.

In carpal tunnel syndrome, the median nerve is trapped, causing pain and motor restraints. "The middle nerve runs through an anatomical constriction on the wrist, the carpal tunnel, " explains Jung. "This tunnel can be thought of as a bony U with a tight band of connective tissue as a roof, " said the doctor. "If the tunnel is additionally narrowed due to pressure, the median nerve is damaged."

The causes for such an increase in pressure are manifold and often can not be completely clarified. For example, swelling caused by rheumatism, a wrist fracture or a tumor can narrow the carpal tunnel. Often also an overload causes the pinching of the nerve. "In most cases, less routine activities, but rather unfamiliar movements are the trigger of the complaints, " says Jung. display

Even a hereditary preload is not excluded. "The carpal tunnel syndrome often occurs over many generations, especially in maternal relatives, " says Hans Assmus, a practicing neurologist from Dossenheim and a member of the German Society for Neurosurgery. "However, heredity is probably more indirect, such as metabolic diseases that favor the carpal tunnel syndrome, " says the Heidelberg orthopedist Jung.

Carpal tunnel syndrome is first diagnosed by several so-called provocation tests that examine the sensitivity of the fingers. In a second step, a neurologist measures the nerve conduction velocity, which must not exceed a certain limit. "However, this measurement must be viewed critically, because often abnormal values ​​occur, although the patient does not complain about the typical symptoms, " says neurosurgeon Assmus. And the orthopedist Jung confirms: "Only both examinations together give a comprehensive picture."

The chances of recovery are usually very good. In mild cases, the patients first receive overnight storage rails that immobilize the wrist. Cortisone injections can also help. In the long term, however, usually only one operation helps. "Such an operation is now a routine procedure and is usually performed on an outpatient basis and rarely under general anesthesia, " says Assmus. During surgery, the surgeons separate the band covering the carpal tunnel and thus relieve the median nerve.

"Which operation method the surgeon uses - open or endoscopic - is discretionary. The chances of success are the same ", explains Assmus. Already on the first day after the procedure, most sufferers feel a significant pain relief. Depending on your job, it will take about three weeks to get your hand back up and running. However, the lost instinct returns only gradually. "Full recovery of the nerve may take up to a few months, depending on the course of the disease, " reports Jung. Patients whose hands often fall asleep and tingle should consult a doctor as soon as possible. For if the carpal tunnel syndrome remains untreated, not only the typical symptoms appear, but the mid-nerve can be irreversibly damaged.

ddp / science.de - Claudia Hilbert

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