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Carpal tunnel syndrome is one of the most common causes of wrist pain, with a particular “preference” for middle-aged menopausal women, but also for those who are pregnant or breastfeeding. Hand pain, burning sensation, a feeling of “needle stings” and numbness in the thumb, the index and middle fingers are typical signs - so doctors can mistakenly diagnose tendonitis or cervical syndrome.
The cause for this painful condition which gets worse, since the patient does not receive the appropriate treatment, is the pressure exerted on the median nerve at the height of the wrist. It is the nerve which is formed in the cervical curve of the spine, courses through the medial surface of the arm and palmar surface of the forearm, and reaches the fingers through the carpal tunnel. This “tunnel” is a fairly narrow cavernous anatomical structure, the roof of which is covered by the transverse ligament (flexor retinaculum), a strong fibrous band.
The reason that carpal tunnel syndrome creates so many hand problems is in the role of the nerve which is compressed: It is about the nerve which supplies the muscles of the hand, while providing sensitivity to the hand, on the part of the thumb, the index and the middle fingers. It also moves the muscles around the thumb. On the other hand, the tendons which are responsible for the flexing of the fingers pass through the carpal tunnel.

Epidemiological studies have shown that early diagnosis is very important, so that the damage to the median nerve does not become permanent. If diagnosis is made early in the course of the condition, the symptoms of carpal tunnel syndrome can be treated conservatively. However, since pain and numbness persist for a long time, and to a point where they affect the patient’s daily routine, open carpal tunnel surgery is performed. The aim is to decompress the nerve through a cross-section of the transverse ligament.

The most modern approach is the endoscopic technique. In relation to classical open surgery, the main advantage is that the use of the arthroscopic camera helps to prevent injuries. Moreover, the minimum number of incisions (one or two), which are much fairly smaller and thus the continuity of the skin and the underlying tissues are preserved, and the scar can be avoided.
The procedure can also be performed under local anesthesia and the patient can return to their daily activities sooner, with the smallest possible restriction of movements at stage one. Usually, after surgery, the doctor recommends that the hand should be placed above the height of the heart in order to reduce swelling and prevent stiffness. For an adequate period of time, there is a minor sensation of pain in the palm. Strength gaining takes place within 2 to 3 months after surgery, however, in cases where the median nerve was in a poor condition, the recovery period can reach up to 6 months.
According to the American Academy of Orthopedic Surgeons (AAOS), if tendinitis or arthritis coexist, recovery time is prolonged, while in cases where there is a severe sensory and / or muscle loss around the base of the thumb, the postoperative course is even slower.

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