Dr.Kamil Pietrasik
language: Polish
|language: English
Carpal tunnel syndrome (CTS) is one of the most frequent hand problems.
It is caused by compression of median nerve in carpal canal by one or few of following reasons:
  • hypertrophy of transverse carpal ligament,
  • edema of flexor tendons sheaths,
  • anatomical abnormalities caused by fracture, luxation and other pathologies of the wrist and distal radius,
  • prolonged wrist extension,
  • fluid retention in pregnancy.

Thyroid hormones imbalance , rheumatoid arthritis, and diabetes my predispose to CTS.

Most frequent manifestations of CTS involve Ist, IInd, IIIrd fingers and may present as:

  • tingling,
  • paresthesia,
  • pain,
  • grip weakening.

Neurological symptoms manifest typically at night. As they progress, patients experience sleeping problems disturbed by severe pain. Weakening of grip manifests by dropping of objects such as glasses or keys.
In end-stage of the disease pain is very severe and function of the hand is completely impaired.

In diagnosis of CTS obtaining of the history from patient and careful examination of the hand play crucial role. Diagnostic studies such as X-ray, ultrasonography (USG), electromyography (EMG) or magnetic resonance (MR) may be used to confirm initial diagnosis.

Treatment of CTS depends on intensity of manifestations and varies from conservative immobilization of the wrist with oral non-steroid anti-inflammatory drugs through rehabilitation with physiotherapy to surgical intervention.

During the operation, transverse carpal ligament is transected and carpal canal is opened what results in release of median nerve. This surgery called "carpal tunnel decompression" may be performed as standard/ open or endoscopis procedure.

Skin incision (4-5cm) in open approach is located on palmar aspect of the wrist within physiological creases. If endoscopic decompression is performed 1 or 2 (1cm) incisions are located in physiological creases of the wrist and palm.

Wrist is immobilized in half-splint for a period of 2 weeks. Fingers movements are not limited and early encouraged.
Although wrist pain is relieved almost immediately after the surgery, it may take several months for entire nerve to regenerate and neurological symptoms to subside.

In postoperative period hand must be kept in elevation till wound heals completely and edema resolves.
Skin sutures are removed 10-14 days after the surgery.

Hand therapy should be started on next day after the surgery and continued for a period of 4-6 weeks.

Return to normal activity involving hands is possible after rehabilitation is complete.
Although results of surgical treatment of CTS are very good and long-lasting, symptoms may reoccur.

This short information doesn’t replace medical consultation in the office.

These pages utilize cookies in accordance with your browser's setting.