Carpal Tunnel Syndrome in India
Carpal Tunnel Syndrome a painful condition of the hand and fingers caused by compression of a major nerve where it passes over the carpal bones through a passage at the front of the wrist. It may be caused by continual repetitive movements or by fluid retention. It is umbness, tingling, weakness, and other problems in your hand because of pressure on the median nerve in your wrist. The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel . The median nerve controls movement and feeling in your thumb and first three fingers (not your little finger).
Pressure on the median nerve causes carpal tunnel syndrome. This pressure can come from swelling or anything that makes the carpal tunnel smaller.
The median nerve is responsible for two main functions:
- Relaying physical sensations – such as your sense of touch from your hand to your brain
- Relaying nerve signals – from your brain to your hand, controlling movement
- Any pressure on the median nerve can disrupt the nerve signals, affecting your sense of touch and hand movements. The median nerve can become compressed if the tissues inside the tunnel become swollen or the tunnel narrows over time.
Causes of Carpal Tunnel Syndrome
Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Most likely the disorder is due to a congenital predisposition – the carpal tunnel is simply smaller in some people than in others, It can be caused due to
- Family history
- Certain health conditions, such as diabetes, an underactive thyroid gland or rheumatoid arthritis
- Certain injuries to the wrist , Wrist dislocation and fracture
- Certain activities
Swelling and inflammation around the tendons
Symptoms of Carpal Tunnel Syndrome
The median nerve passes through the carpal tunnel in the wrist and controls some of the movements of the thumb, as well as sensation in the thumb and the next two-and-a-half fingers.
The symptoms of CTS tend to develop gradually and usually start off being worse at night or early in the morning.
- A dull ache and discomfort in the hand, forearm or upper arm
- A burning, prickling sensation (paraesthesia) in the hand similar to pins and needles
- dry skin, swelling or changes in the skin colour of the hand
- becoming less sensitive to touch (hypoaesthesia)
- weakness and wasting away (atrophy) of the muscles at the base of the thumb
- Difficulty in dropping objects or getting hold of the object with the hands
- Difficulty in making a fist
These symptoms occur in:
- the thumb
- the index finger
- the middle finger
- half of the ring finger
However, the tingling, numbness and pain can sometimes extend outside this area.
Diagnosis of Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) can usually be diagnosed by your surgeon, who will examine your hand and wrist and ask you about your symptoms.
Your doctor may tap your wrist lightly to see if you feel tingling or numbness in your fingers, although this test is not reliable.
Flexing your wrist or holding it elevated above the head for a minute are other commonly performed simple tests for CTS, and should induce the same pain, numbness or tingling in your hand if you have the condition
A blood test is conducted if the doctor suspects an underlying condition relating to CTS, such as:
- Rheumatoid arthritis
- Underactive thyroid gland (hypothyroidism)
Nerve conduction study
A nerve conduction study is a test that measures how fast signals are transmitted through your nerves. During the test, electrodes are placed on your hand and wrist and a small electrical current is used to stimulate the nerves in the finger, wrist and, sometimes, elbow.
The results from the test indicate how much damage there is to your nerves.
Electromyography (EMG) provides useful information about how well your muscles are able to respond when a nerve is stimulated, indicating any nerve damage.
During the test, fine needles are inserted into your muscles. The needles detect any natural electrical activity given off by your muscles
An X-ray may be recommended, but usually only to aid in the diagnosis of fractures and other disorders such as rheumatoid arthritis
Carpal Tunnel Syndrome Treatment.
Treatment of carpal tunnel syndrome depends on how severe your pain and symptoms are and if there is weakness..
Nonsurgical options include:
- Avoiding positions that overextend your wrist
- Wrist splints that hold your hand in a neutral position, especially at night
- Mild pain medication and medications to reduce inflammation
- Treatment of any underlying conditions you may have, such as diabetes or arthritis
- Steroid injections into your carpal tunnel area to reduce inflammation
Surgery may be necessary if there’s severe damage to your median nerve. Surgery for carpal tunnel syndrome involves cutting the band of tissue in the wrist that crosses the median nerve so as to lessen the pressure on your nerve. Factors that determine success or failure are age of the patient, duration of symptoms, diabetes mellitus, and if there is weakness (which usually is a late sign). Key hole and open surgery are the two types of CTS surgery.
A single cut (about 5cm long) is made in the front of the wrist at the base of your palm. Your surgeon opens the carpal tunnel and cuts the ligament to relieve the pressure on your nerve
A small cut (about 2cm long) is made in your forearm just above the wrist or in the palm of your hand. A thin flexible telescope (endoscope) is passed into the cut to help see inside the wrist either by looking directly through this, or at pictures it sends to a video screen. Using a special instrument attached to the endoscope the ligament is cut.
After surgery, the skin cut is usually closed with dissolvable stitches. The operation can take 10 to 20 minutes.
Cost of Carpal Tunnel Syndrome Surgery
One of The main benefits of India is that carpal tunnel syndrome surgery cost is very low and also all the hospitals offer more advanced technology.