The nerve fibers running through the body can be attacked in different ways. First, a distinction is made between localized nerve bottleneck syndromes (such as carpal tunnel syndrome or ulnar groove syndrome) and generalized nerve diseases (polyneuropathies). In local nerve constriction syndromes, irritation or constriction of a nerve occurs due to mechanical stress: certain very frequently performed movements. Due to constrictions present on the body, or favored by certain pre-existing conditions it can usually be treated well. One of the most common constriction syndromes is the
When tingling or stabbing sensations or pain in the fingers (usually I-IV) occur, especially at night or during stress at the wrist (repetitive bending and stretching movements in the wrist, working with vibrating tools), a carpal tunnel syndrome must be considered. The symptoms typically improve with shaking of the hand. In advanced stages, weakness of the hand may be added, objects fall out of the hand and the muscle of the thumb shrinks.
The cause is chronic pressure damage to the median nerve in the region of the carpal bones, where the nerve is compressed under a tendon (lig. carpi transversum) in a physiological bottleneck. The syndrome occurs about twice as often in women, usually in middle age; in just under half of cases, both sides are affected.
The diagnosis is made on the basis of the examination findings and with the help of additional technical examinations (measurement of nerve conduction velocity, EMG, ultrasound, possibly laboratory or imaging). It is particularly important to differentiate the diagnosis from other causes (damage to nerve roots, neuropathies, etc.)
In treatment, one initially relies on manual rest or nightly splinting of the wrist in the middle position. Also decongestant drugs can be used. In many cases, surgical relief of the nerve in the area of the tightness proves to be the best long-term therapy, but the special expertise of the surgeon should be ensured.
As experts in Munich, we will be happy to assist you with the diagnosis and treatment or consultation.