Carpal tunnel syndrome is a common and painful disorder caused by compression of the median nerve within the carpal tunnel at the wrist. Carpal tunnel surgery is performed to relieve the pressure on the nerve so that normal nerve conduction may take place again.
Two major nerves pass from the forearm into the hand - the large median nerve and the smaller ulnar nerve. Both cross the front of the wrist, the median nerve centrally and the ulnar nerve to the little finger side, within a passage known as the carpal tunnel.
Many tendons passing to the fingers from the forearm muscles also pass along the front of the wrist in the carpal tunnel. To prevent these from bowing forward when the wrist and fingers are bent, there is a strong tendinous strap across the front of the wrist. This is called the transverse carpal ligament, or flexor retinaculum.
The median nerve controls sensation and movement in the fingers. There is little free space under the transverse carpal ligament and, should any swelling occur, the large median nerve can readily be compressed, causing carpal tunnel syndrome.
Carpal tunnel syndrome is often caused by repetitive and forceful movement of the wrist. This results in inflammation of the tendons that line the carpal tunnel area. Thus, it can be prevented by avoiding these types of movements at work or in leisure activities.
Treatment may involve the use of antinflammatory medications such as aspirin or NSAIDs with or without the use of splints or other aids that limit the motion of the wrist. Surgery is necessary if compression of the nerve leads to signs of wasting in the muscles activated by the median nerve. Obvious wasting is a sign of an advanced stage of compression of the nerve. Carpal tunnel can occur in one or both hands.
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