Release of median or ulnar nerve in the wrist

Carpal tunnel syndrome – a common wrist problem

The carpal tunnel or wrist median is a narrow tunnel in the wrist. The median nerve is located in this tunnel, along with nine tendons, which move the hand and fingers. It is well-protected from direct blows and can perform its tasks – the sensors are handled by the thumb, index finger, middle finger and the thumb side of the ring finger. The motor part is handled by the thumb muscles. 

Pressure on the nerve leads to disturbance in sensory activity – tingling sensation and pain. If the pressure is not releases, the motor strings are also damaged and a syndrome develops, which is characterized by muscle weakness of hands and related clumsiness of the fingers, objects dropped from the hand and similar nuisances. 

Often, carpal tunnel syndrome occurs together with a systemic disease, which mostly affects the joints and is known as rheumatism. It is the most common form of systemic disease of the joints, rheumatoid arthritis. 

First symptoms

The disease begins gradually with mild pain in the wrist, which can extend to the area of the palm, on the inside of the forearm or even to the shoulders. All fingers, except the little one, experience a tingling sensation and become numb after holding the wrist for a longer or even shorter period of time. 

Problems are more pronounced at night – especially towards morning – than during the day. Shaking out the hands temporarily reduces the problem. The more the disease progresses, the worse the perception of touching with the fingers is. Finally, they become totally insensitive or deaf to the touch, the hand becomes weaker and clumsier. 

Treatment

As long as the problems are mild and of a transient nature, it is possible to manage them by taking several breaks when doing work that is a burden on the wrist. When such problems persist, despite using this method, or if the situation becomes even worse, there are the options of immobilization, medication or surgery. 

The operation is carried out under local anaesthesia. The nerve can be relaxed through a classic open or endoscopic method. The operation is short; it lasts from ten to fifteen minutes. The surgical procedure, followed by two months of rehabilitation, dramatically improves the situation.