The syndrome carpal tunnel is an expression of the lesion produced by entrapping or compression of the median nerve (one of the nerves going to the hand).
Nerve damage is known as peripheral neuropathy and it is a nuisance that affects 3% of the general population and up to 15% of the economically active population.
The working population is exposed to occupational risk factors that worsen the symptoms of carpal tunnel syndrome, which can cause a significant disability that affects the effectiveness and production in daily work in different sectors of the econom.
The carpal tunnel is a channel or slide at the level of the anterior aspect of the wrist, between the bones of the joint and the annular ligament of the Carpus, through which the flexor tendons of the fingers of the hand and the median nerve pass.
Any process that generates chronic inflammation at the wrist level can produce compression of the nerve and therefore trigger the symptoms of carpal tunnel syndrome.
The professions that most frequently develop this type of pathology are those that carry out manual work, such as workers in the food area (butchers, butchers, farmers), carpentry, hairdressing, textile industry, shoemaking, electronics, office work, collection boxes, informatics, even in health branches, such as dentistry and some surgical specialties.
Risk factors for developing carpal tunnel syndrome
The factors that increase the probability of suffering from carpal tunnel syndrome are:
• Female gender and age.
• Family members with carpal tunnel syndrome.
• Associated endocrine pathologies such as Diabetes Mellitus, hypothyroidism, metabolic syndrome and obesity.
• Rheumatoid arthritis.
• Anatomical factors, such as fractures or dislocations.
• Menopause.
• Low size.
• Smoking
• Use of oral contraceptives.
Symptoms of carpal tunnel syndrome
While it is true that symptoms usually appear in people who have a work exercise that includes repetitive movements of the wrist, it can also appear in people with fractures and tumors that compress the wrist.
One of the characteristics of this disease is that the clinical symptoms increase with the activity of the affected wrist and usually remit by shaking or massaging the joint or raising the affected forearm, since with these movements blood return improves and allows partial decompression and momentary wrist.
The symptoms of carpal tunnel syndrome manifest with different sensations such as heat, cramps, tingling or numbness in the palm and fingers of the hand, especially the thumb and the middle and index fingers.
Symptoms usually begin gradually or progressively and often appear at night in one or both hands, with a numbness and tingling sensation in the fingertips, caused by sleeping with the wrists bent.
As the symptoms progress, patients begin to feel the symptoms of numbness and cramps in the daylight hours. It may be difficult to make a fist, grasp small objects, or perform other manual tasks.
In chronic cases that are not adequately treated, the muscles at the base of the thumb may weaken or atrophy. Loss of discrimination between hot and cold sensations may also be experienced in localized areas of the hand. At other times, severe pain and / or numbness may occur in the wrist and upper hand.
Treatment of carpal tunnel syndrome
There are several conservative treatments capable of improving symptoms and restoring previous function in patients with mild to moderate carpal tunnel syndrome, however, in severe cases treatment is usually surgical.
The conservative measures that have been considered for the initial treatment of this pathology are local and systemic steroids and non-steroidal anti-inflammatory drugs.
The use of immobilizations such as splints, local injections of analgesics and muscle relaxants, electrotherapy techniques, manual therapies and neural gliding exercises are also included, as well as the combination of several of these options.
In the case of surgery, the results of some studies in terms of improvement of symptoms and functional capacity show encouraging evidence that justifies it in older people, but the results in young patients are more controversial.
For all this, every patient must be carefully studied by the trauma doctor or hand surgeon, who determines, together with the patient, the different therapeutic options that are adjusted to each person according to various factors to evaluate, such as age. and occupation, mainly.

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