Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is an entrapment of median nerve within carpal tunnel resulting in severe pain, tingling and numbness along the course of median nerve.
Causes of Carpal Tunnel Syndrome:
- Lipoma, Ganglion or bursitis.
- Vascular malformation.
- Median nerve neuropathy.
The Flexor Retinaculum:
- Strong, fibrous band that arches over the wrist.
- Attached to wrist bones.
- Medially attached to hamate and pisiform bones.
- Laterally attached to scaphoid and trapezium bones.
- Carpal tunnel
- Shaped as Concave arch.
- Lies between flexor retinaculum and wrist bone.
- Holds the median nerve and the flexor tendons.
- Total of nine flexor tendonspass through the carpal tunnel.
- Rectangular in shape
- Situated under skin and subcutaneous tissue.
- Median nerve passes through carpal tunnel.
- Ulnar nerve lies outside tunnel over surface of flexor retinaculum.
The medial nerve when pinched causes severe intractable pain,tingling, numbness and weakness. Symptoms are spread over thumb, index finger, middle finger, and half of the ring finger. Numbness is often associated with weakness of digital muscles.
- Conservative treatment includes
- Anti-inflammatory medications
- Physical therapy and
- Corticosteroid injection
- Surgery is to divide the transverse carpal ligament in two.