Orthopedics-Online

Symptoms of carpal tunnel syndrome

introduction

The patient's symptoms (clinic) depend on the root cause, the extent and the Duration of injury.

The Carpal tunnel syndrome often begins with the so-called Fall asleep and "Ant running“(= Tingling) on the tip of the middle finger. By a one-sided posture of the wrist The complaints are triggered when telephoning, cycling, working with strongly vibrating tools or during office activities with frequent work on the PC. A short time later, the patient has it Sensation of swollen hand.

Characteristic features

The most characteristic feature of a carpal tunnel syndrome, however, is the night or morning falling asleep of the hand and radiating hand / arm pain (Brachialgia paraesthetica nocturna). The patient's sleep is disturbed by the pain and abnormal sensations (paresthesia). An attempt is often made to drive away the emotional disturbance by rubbing or shaking the hand.

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typical symptoms

Nocturnal complaints such as "falling asleep" of the palm and thumb, index finger and middle finger
Pain
- In the early stages after exercise
- In the late stages spontaneously or even permanently
Paresthesia: numbness, "falling asleep" of the hand
- Tingling, "pins and needles" in fingers and palms
Stiff and swollen fingers in the morning
Hypesthesia: deterioration of the sense of touch and loss of sensitivity
Ball of the thumb atrophy: muscle wasting on the thumb

night pain

Nocturnal pain and poor sensation in the fingers and palm are typical early symptoms of carpal tunnel syndrome. The thumb, index finger and middle finger as well as the palm of the hand are particularly affected. Often the sick wake up due to the nightly pain and abnormal sensations.

Typically, the discomfort is improved by shaking and massaging the hand. The nocturnal pain is perceived as extremely annoying and has a negative effect on sleep behavior. If those affected often wake up from pain at night, daytime sleepiness and poor concentration can be expected the next day.

For more information see: Numbness in the hand.

Tingling sensation and numbness

The symptoms characteristic of carpal tunnel syndrome, tingling and numbness, are so-called paresthesias, abnormal sensations of the skin. The tingling sensation is a discomfort on the body surface that is perceived by those affected as extremely annoying and unpleasant. Those affected describe the tingling sensation as "pins and needles" on the skin or touching a nettle.

A feeling of numbness is accompanied by a significantly reduced sense of touch. The affected parts of the body feel numb to the sick person. Many sufferers also feel that the affected areas have fallen asleep. Touch, temperature and pain sensation are enormously reduced. The discomfort, tingling and numbness, often begins on the fingers, especially the middle finger, index finger and thumb. The paresthesia can affect the palm and radiate into the forearm.

Also read the article: Tingling in hand.

Ball of the thumb atrophy

The thumb ball atrophy describes the muscle wasting in the area of the ball of the thumb. It is a classic late symptom of carpal tunnel syndrome if it is left untreated. The muscles of the ball of the thumb, abductor pollicis brevis and opponens policis muscles, lose muscle mass. Muscle loss is particularly noticeable when grasping or opening and closing a bottle. These movements are significantly hindered due to the ball of the thumb atrophy.

Causes of Carpal Tunnel Syndrome

Carpal tunnel syndrome can have several causes. A naturally tight carpal tunnel, excessive stress on the wrist, injuries and inflammatory changes all promote the development of carpal tunnel syndrome.

The carpal tunnel is actually an anatomical, tunnel-like passage for tendons and nerves in the hand. An important nerve lies in this tunnel, the median nerve. Due to the disease-related bottleneck in the carpal tunnel, the median nerve is mechanically stressed and irritated. The injury to the sensitive nerve leads to the fact that it is disturbed in its tasks. The nerve supplies the ball of the thumb muscles and is responsible for the sensitive sensation of the thumb, index finger, middle finger and parts of the ring finger. The pressure on the nerve in the narrow carpal tunnel causes abnormal sensations in the nerve supply area.

Those affected therefore suffer from tingling, "pins and needles", numbness and pain in the fingers and palms of the hands. The symptoms can radiate into the arm. If carpal tunnel syndrome is left untreated for a long time, the nerve damage progresses and over time the muscles of the ball of the thumb atrophy. This is because the pressure on the nerves over time damages all of the supply areas of the median nerve. This also includes the ball of the thumb, which can be used less and thus loses function and muscle mass.

Please also read: Causes of Carpal Tunnel Syndrome

Can carpal tunnel syndrome also have symptoms in other areas such as the shoulder or arm?

A carpal tunnel syndrome triggers typical symptoms such as pain and paresthesia in the supply area of the affected median nerve. The palm and thumb, index finger and ring finger are particularly affected. However, the symptoms, both the pain and the discomfort such as tingling or pins and needles, can radiate. It is possible that the symptoms extend into the arm or even the shoulder and neck area.

course

The course of a carpal tunnel syndrome is very variable. The symptoms can be chronically progressive, recurring with pauses or spontaneously disappear again. The latter occurs especially in younger patients, for example after completing a pregnancy or after reducing a discomfort-causing activity. The longer a carpal tunnel syndrome has existed and the older the patient, the less likely it is that their symptoms will improve spontaneously.

Initial stage

In the early stages of the disease, which can drag on for years, this may also succeed. The cause of these nocturnal complaints lies in the unnoticed kinking of the hand in sleepwhereby a Pressure increase in the carpal tunnel is generated, which in already tight conditions leads to exhaustion of the nerve adaptation to the changed conditions and the median nerve is thus pressure-damaged. By changing the position of the wrist, the reserve space can be sufficient again, the nerve can recover, so that the symptoms initially disappear again. A wrist splint, for example, is suitable for this.

Advanced stage

However, the greater the tightness in the carpal tunnel, the slower the recovery will take place until it finally becomes one persistent emotional disorder comes. This sensory disorder affects the thumb, index finger, middle finger, and ring finger on the palm side. Exist particularly often tingling Sensory disturbances in the middle three fingers.
The Radiation of pain starting from the hand, mostly also affects the forearm and can even do the shoulder to reach. In the course of the disease, it is not just the nightly pain and abnormal sensations. The symptoms also appear more and more frequently during the day on. In addition, as the disease progresses, the damage also increasingly affects the Function of the wrist muscles. In this regard, patients often report "clumsiness" and sudden "weakness" of the hand.

They report on suddenly dropped glasses or bottles, but also that Difficulty in picking up the grip exist between thumb and forefinger. The Sensitivity the skin on the thumb, index, middle and ring fingers reduced always further. The key recognition is ultimately disturbed. In the advanced stages of the disease it can become visible Loss of the ball of the thumb (Atrophy) come. Firm gripping of the hand is then no longer possible.

Fortunately, the complete loss of feeling on the skin in the hand is very rare these days.

Is there a carpal tunnel syndrome also on the foot?

A carpal tunnel syndrome is by definition localized in the area of the wrist, since this is where the anatomical structure, the carpal tunnel, is located. The carpal tunnel syndrome is a nerve congestion syndrome.

One possible nerve bottleneck syndrome in the foot is the so-called tarsal tunnel syndrome, which sounds similar to the carpal tunnel syndrome. The tarsal tunnel is an anatomical structure in the area of the ankle that can also be narrowed. In this case, the symptoms are similar to those that occur in the hand with carpal tunnel syndrome. Tarsal tunnel syndrome causes nightly pain and abnormal sensations such as tingling and numbness in the toes and the soles of the feet. The symptoms can extend to the calves.

Summary

To the classic complaint constellations in carpal tunnel syndrome belong to the nocturnal pain at rest of the hand as well Sensory disturbances on the fingers.

If the symptoms persist, a doctor should be consulted in order to avoid permanent damage and to be able to start treatment early.