Anatomy of Volar Wrist Pain
It includes ulnar artery, ulnar nerve, superficial palmar arch, median nerve, and radial artery, the flexor tendons of the wrist and hand, the hypothenar muscles, the thenar muscles, and the transverse carpal ligament. There are eight carpal bones of wrist that fit into the shallow socket formed by bones of forearm that is ulna, radius, and carpal bones, the scaphoid, the lunate, the triquetrum, the pisiform, the trapezium, trapezoid, capitate, hamate.
Carpal tunnel syndrome is pressure on median nerve due to thickening of transverse carpal ligament. In carpal tunnel syndrome, the transverse carpal ligament in the median nerve goes behind it or almost below it.
Thenar Atrophy is commonly associated with severe carpal tunnel syndrome. Carpal tunnel syndrome can occur during pregnancy because of swelling that will compress the median nerve of the hand causing the finger to feel numb. These symptoms typically go away after delivery of the baby.
Common Causes of carpal tunnel include obesity, hypothyroidism, arthritis, diabetes, and trauma. Also, it can be associated with different jobs like typing, lifting, or jobs that require exposure to vibrations. This syndrome can lead to numbness, tingling, and weakness in the hand and fingers. This numbness usually occurs at night because we tend to sleep keeping our wrist flexed.
Tinel's Test is helpful for median nerve. Tapping on the nerve will reduce the symptoms. Phalen's maneuver is a diagnostic test to determine if the patient has carpal tunnel syndrome or not. By flexing the wrist, the patient will complain of carpal tunnel symptoms.
Treatment Includes antiinflammatory medications, splints, therapy, injections, carpal tunnel release. The release is done by cutting through the transverse carpal ligament. This release of ligament decompresses the nerve and improves condition of the hand and fingers. It is similar to a tunnel being open or widened so that the large truck can pass through it.