S.i is by far the most common disorder affecting the hand among the population. Let’s talk about the carpal tunnel syndromea pathology that it affects women with a greater incidence and which, if neglected, can cause irreversible damage.
Although they are undoubtedly the part of the body that we use most often in everyday life, hands and their health tend to be often neglected with the risk of long drag on what seem like little annoyances but that may actually turn out to be a sign of a problem.
So what is carpal tunnel syndrome? How does it manifest itself? And what treatments are available today? To answer the most frequent doubts but also for dispel some myths still deeply rooted, we asked a few questions to Professor Giorgio Pajardi, Director of the Hand Surgery Unit of the MultiMedica Group and Professor at the University of Milan.
Carpal tunnel syndrome: what it is
“Carpal tunnel syndrome is one irritative state of the median nerve in its passage from the forearm to the hand. – explains Professor Pajardi – When we talk about nerves we must know that the critical points are those in which an articulation jump is made: from the neck to the shoulder, from the shoulder to the arm, from the arm to the forearm and finally from the forearm to the palm of the hand and wrist. Of all the joints, the one that has greater mobility and that is used more than the others is undoubtedly that of the hand and wrist “.
Why median nerve health is so important
“The median nerve is very important because it gives sensitivity to the thumb, index, middle finger and part of the ring finger. – continues the expert – In addition to ensuring mobility to all the muscles at the base of the thumb that are called mount of Venus. Not only that, the median is the nerve that allows us to have an opposable thumb and which guarantees the grip of the hand, which is the main characteristic of man ».
Symptoms not to be underestimated
It is therefore clearly understood because damage to this type of nerve can have very serious repercussions on our abilities and on the ability to perform the most common daily actions normally. However, carpal tunnel syndrome occurs initially with little annoyances which generally do not particularly concern those who suffer from it.
“It’s about signals that are systematically ignored – Professor Pajardi points out – how tingling or numbness in the fingers which usually occurs when the hand is still in a stable position, such as in the morning as soon as you wake up, with a slightly extended wrist. The sensitivity and mobility of the hand, however, are perfect and therefore the patient tends not to pay too much attention to it “.
The importance of early diagnosis
Often we tend to ignore the disturbance because the discomfort is thought to be caused by an incorrect posture, however underestimating this stage can be risky. “When these first signs appear it is good to investigate because in reality the nerve already suffers – specifies the expert – however, being still fully functional, it offers the ideal condition to intervene promptly and solve the problem. When, on the other hand, the suffering continues over time, for months or even years, the annoyance becomes more and more a real pain, with sudden twinges and numb touch, as if there was a small piece of scotch tape on the fingertips, to get an idea. Not only that, too the fine grip begins to be less precise, it may happen that objects get out of hand. At this point we are no longer talking about a functioning nerve but about one decrease in nerve performance which can have important repercussions “.
How the diagnosis is made
So how to understand if the discomfort experienced is due to the carpal tunnel? “The main exam is theelectromyography which allows to measure the natural electrical activity of the muscles through electrodes – Professor Pajardi specifies – often associated ultrasound of the nerve which instead allows to reveal the morphology and therefore to see if the nerve is pinched. They are important elements for quantify the damage and assess the prognosis. If the nerve is very compromised, in fact, the intervention resolves the pain condition but small disturbances such as a slight numbness may remain and it is right that the patient is adequately informed ».
How is carpal tunnel syndrome treated?
Once it is established that it is carpal tunnel syndrome, what to do? «In the initial phase you can intervene with an unloading brace night – suggests the expert – The hand surgeon must always be accompanied by a specialized hand therapist who purposely makes a brace for the patient and teaches rehabilitation exercises, called neurodynamics ».
At this stage, however, to solve the problem, it must necessarily follow the intervention. «This is a targeted endoscopic operation – explains Professor Pajardi – is carried out in day hospital with anesthesia. At the end of the surgery the patient is kept under observation for about an hour and then sent home with the hand that can already be moved. In the following days the hand therapist can provide exercises to stimulate the sensitivity and muscles of the thumbso as to be able to recover as much as possible the functionality of the limb ».
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Is it really the mouse’s fault?
In the past it was thought that carpal tunnel syndrome could be caused by incorrect positions and habitssuch as, for example, that linked to the prolonged use of mouse. “In reality it is a false myth – Professor Pajardi specifies – just think that it is historically proven that Giuseppe Garibaldi also suffered from carpal tunnel syndrome.
It is true rather than the pathology can be more evident during certain activities which are carried out daily but which cannot be considered the cause of the disturbance “.
Another well-established belief is that carpal tunnel syndrome primarily affects people of a certain age. «As we said, it is a very widespread pathology linked to a more vulnerable area than others – explains the expert – and for this reason it can also affect young people. There are even pediatric forms of carpal tunnel, although fortunately very rare “.
Carpal tunnel syndrome: new mothers are more at risk
Finally, although it is little known, carpal tunnel syndrome also affects the new mothers. “About half of new mothers experience some form of hand disorder, with symptoms ranging from decreased tactile perception and movement to motor problems characterized by less force in holding objects – explains Dr. Stefano Bianchi, Director of Maternal-Infantile Department of the San Giuseppe Hospital and Professor at the University of Milan – These are phenomena that they appear mainly in the last trimester of pregnancyinduced by hormonal changes, the redistribution of body fluids and an alteration in the structure of the ligaments, but which are especially accentuated after childbirth, in the early stages of breastfeeding, also favored by the new gestures required to take care of the newborn ». In light of these evidences, the San Giuseppe Hospital in Milan has foreseen special “lessons” of postural re-education provided to pregnant women within the birth preparation courses.
“In most cases, the carpal tunnel syndrome developed by the new mother it tends to resolve spontaneously – concludes Professor Pajardi – in fact, these are mild forms that do not become chronic.
Nonetheless, it’s important to get the message across that, with adequate postural precautionsthe main disorders affecting the hand can be managed if not completely prevented “.
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