Carpal Tunnel Syndrome ∞ Area

Carpal Tunnel Syndrome

Meaning

Carpal Tunnel Syndrome is a clinical condition resulting from compression of the median nerve within the carpal tunnel of the wrist. This compression typically manifests as sensory disturbances, including numbness, tingling, and pain, primarily affecting the thumb, index, middle, and radial half of the ring finger, sometimes accompanied by motor weakness.

Context

The carpal tunnel is a confined anatomical passageway at the wrist, bounded by carpal bones and the transverse carpal ligament. Within this restrictive space, the median nerve coexists with nine flexor tendons. Any increased volume or reduced tunnel capacity directly exerts pressure on the median nerve.

Significance

Clinically, Carpal Tunnel Syndrome is a common peripheral mononeuropathy significantly impacting hand function and quality of life. Prompt diagnosis is crucial to prevent progressive nerve damage and preserve sensory perception and fine motor skills. Untreated compression can lead to chronic discomfort and irreversible neurological deficits.

Mechanism

The pathophysiology involves elevated pressure within the carpal tunnel, directly impairing the median nerve’s microcirculation and axoplasmic flow. This sustained compression causes localized ischemia and demyelination of nerve fibers, potentially leading to axonal degeneration. Factors like tenosynovitis, fluid retention, or wrist trauma contribute to this pressure increase.

Application

Clinical presentation often includes nocturnal paresthesia, with symptoms worsening during repetitive hand activities or sustained wrist flexion. Management ranges from conservative measures like nocturnal wrist splinting, oral anti-inflammatory agents, and local corticosteroid injections, to surgical decompression involving division of the transverse carpal ligament. Ergonomic modifications are also key.

Metric

Diagnosis relies on thorough clinical evaluation, incorporating provocative maneuvers such as Phalen’s test and Tinel’s sign. Objective confirmation and severity assessment are achieved through electrodiagnostic studies, specifically nerve conduction velocity (NCV) tests and electromyography (EMG), which quantify median nerve latency, amplitude, and conduction block, providing precise data.

Risk

Failure to adequately address Carpal Tunnel Syndrome risks progressive, irreversible median nerve damage, resulting in permanent sensory loss and thenar muscle atrophy. Surgical intervention, while generally effective, carries potential risks including infection, scar tenderness, incomplete nerve decompression, or, rarely, iatrogenic nerve injury. Adherence to medical guidance is essential.

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