The Carpal Tunnel is an area enclosed by the wrist bones and the Carpal ligament passing through the wrist. The tendons bending the fingers pass through this space, as well as the median nerve responsible for sensation in the thumb, the pointing finger, the index finger and half of the ring finger and allowing the thumb's circular movement.

What causes the Carpal Tunnel Syndrome?

The Carpal Tunnel Syndrome is caused by pressure on the median nerve. Pressure on the median nerve may be created by direct injury of the wrist or by the development of an inflammation causing swelling, an increased pressure within the Carpal Tunnel, stiffening and pressure on the median nerve and restriction of blood supply to it.

What characterizes the Carpal Tunnel Syndrome?

The Carpal Tunnel Syndrome's characteristics arte gradual and usually start with the feeling of paresthesia of the fingers at night. When the problem intensifies the paresthesia becomes chronic and followed by pain in the back of the hand, the arm and even the shoulder and reduces the strength of the finger and palm muscles, impairing the palm's functions.

Are the reasons for the Carpal Tunnel Syndrome?

Congenial narrowing of the Carpal Tunnel

Hormonal changes such as: menopause, Diabetes Mellitus, thyroid problems, pregnancy (usually due to edemas)

Rheumatic disease such as arthritis.

Trauma (injury) of the wrist

Movement of the hand at work – repeated movement, incorrect placement of the hand (holding the computer "mouse")

How is the syndrome diagnosed?

An orthopedic examination for the signs of muscle weakness and reduced sensation.

Tinel's Sign - where knocking on the carpal tunnel area is used to check the appearance of the Carpal Tunnel Syndrome.

Phalen's Test - in which the appearance of the characteristics is checked by bending the backs on the hands towards each other for half a minute.

Electric conductive test - EMG - providing an assessment for the injury's severity though the neural conduction of the median nerve.

Treating the Carpal Tunnel Syndrome

Conservative treatment -

When the cause for the syndrome comes from pregnancy, obesity or a thyroid issue, the cause is treated leading in most cases to the syndrome's disappearance. It is possible to combine this with strengthening and stretching exercises for the area.

Rest and support of the wrist by splint for the duration of the night.

 

Pharmacological treatment -

Ant-inflammatory medications and steroid injections.

 

Surgical treatment -

Surgical treatment is performed under local anesthesia for the purpose of reducing the internal pressure in the carpal tunnel, in two methods:

Open surgery, which involves a cut, several centimeters in length, of the Carpal ligament

Endoscopic surgery, micro-invasive, in which the Carpal ligament is cut by a miniature surgical instrument inserted into the carpal tunnel through a cut 1cm in length. Recovery time is shorter after the endoscopic surgery

CTS- Carpal Tunnel Syndrom

Dr. Alon Covo

drcovo.com
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"Shiba" Medical Center Tel HashomerHand surgery department

Ramat GanShai Medical Center– Private Medical Service Tel Hashomer, 4th Gildsgaim St.

Kfar Saba: Eli Horowitz 12.

Postal AddressDr. Alon Covo, 10th HaGanim St.

P.O. Box 3824 Hod Hasharon 4522174.

E-Mail: drcovo@drcovo.com

Appointments and messages054-7232194

מרכז רפואי "שיבא" תל השומר: המחלקה לכירורגיה של היד

מרפאת רמת גן: מרכז רפואי שי- שר"פ תל השומר, רחוב גילדסגיים 4.

מרפאת כפר סבא: מדיקל השרון- רחוב אלי הורביץ 12.

כתובת למשלוח דואר: ד"ר אלון קובו, רחוב הגנים 10 ת.ד. 3824,

הוד השרון, 4522174

דוא"ל: drcovo@drcovo.com

טלפון לזימון תורים והשארת הודעות: 054-7232194

המידע, העצות והתרגילים באתר הינם כללים וחלקיים בלבד ואינם באים להחליף יעוץ אישי מקצועי של רופא.

ד"ר קובו אינו אחראי לנזק שיגרם עקב הסתמכות על מידע זה, ולהתאמת או אי התאמת המידע, העצות והטיפולים לכל מטופל. המידע, העצות והתרגילים אינם מהווים תחליף או תוספת לפרוטוקול הרפואי.

המידע המובא באתר הינו כללי ומשותף לכלל הגולשים ולא חלה עליו סודיות מידע. בכל מקרה של סיבוך באזור הכאב או ספק או שאלה לגבי המידע שניתן באתר, יש לפנות מיד לרופא המטפל.

The information, advice and practices given in this web page are general and partial only and do not seek to replace professional personal advice given by a physician.

Dr. Covo bears no responsibility to any damage caused based on this information or to the degree in which the information, advice and treatment fit each and every patient. The information, advice and practices do not come as replacement or addition to the medical protocol. The information given in this site is general and common to all visitors and is not subject to confidentiality

In any case of complication in the area of the pain, of doubt or question about the information given in this web page, it is important to contact the treating physician immediately.