The carpal tunnel is a canal in the wrist formed by the carpal bones and transverse carpal ligament; go into this hole nerves, vascular tissue and tendons of the hand.

The carpal tunnel syndrome was the neuropathy due to compression of the median nerve at the wrist that is a deputy to collect the sensitivity of the first three fingers (thumb, index, middle) and the fourth finger (ring finger) and also controls certain muscles that allow the movement of the thumb. The first symptoms of inflammation manifested by tingling, numbness or swelling of the hand, prevailing on the first three fingers and part of the fourth finger: this phenomena, in the early stages, are most noticeable in the morning and at night; in the late phase pain expands the forearm, until reaching the loss of sensation in the fingers and loss of strength of the hand. The symptoms are exacerbated during cold periods and improve during the warm months, although they remain the same disease severity. The carpal tunnel syndrome is triggered by mechanical injury, in which nerve fibers are damaged by ischemic lesions, in which we compress the blood vessels supplying the median nerve, we can also see a narrowing of the carpal tunnel that can be congenital or due to other diseases such as rheumatoid arthritis or diabetes, hypoparathyroidism, amyloidosis or local causes (osteoarthritis). Other causes may be particular postures, fractures, repetitive microtrauma, repetitive tasks. The statistics show that women, on average, are more affected than men, while the onset of the disease is to the 40-60 years. In about 70% of cases the disease involves both hands (bilateral), with prevalence of the dominant hand (right then left to right handed and left-handers). The diagnosis can be made by magnetic resonance imaging, ultrasound or electromyography. These tests, besides allowing to classify the severity of the disease, allow to understand if it is in the presence of a carpal tunnel syndrome or other radiculopathies cervical, brachial plexus or polyneuropathy in general, which can give rise to symptoms very similar to those of the tunnel Carpal. If the carpal tunnel syndrome, is secondary to other diseases, we must first cure such diseases, and if it is primary, you can act conservatively or surgically. Conservative therapy may be of non-steroid or steroid. The non-steroid therapy is to suspend its activities involving the wrist flexion-extension (those responsible for the syndrome) and possibly the joint is immobilized with a splint administering non-steroidal anti-inflammatory drugs. Steroid therapy is to use anti-inflammatory drugs (such as cortisone). When conservative treatment does not lead to benefits need surgical intervention. This can be accomplished with traditional technique or endoscopic, or brachial artery under local anesthesia. The procedure consists in decompression of the median nerve by section of the transverse carpal ligament that leads to immediate disappearance of painful symptoms. The recovery is about 20 days.

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