Carpal tunnel syndrome

It is the most widespread compressive pathology of the peripheral nerve in the human body.

The aforementioned syndrome is caused by the pressure of the surrounding structures on the central nerve in the root area of the hand.

The carpal tunnel consists of eight small bones from the underside of the wrist, and the upper side, closed by the firm connective tissue, i.e. the ligamental structure. Through the tunnel, the median nerve comes from the forearm into the fist and the muscles of the fingers. The tendons are coated with a thin synovial tunica.

Why does this syndrome occur?

Primarily because of increased use of the wrists, i.e. too much strain of the tendons in the carpal tunnel (e.g. excessive work on a keyboard, frequent with manual laborers, surgeons, physiotherapists, masseuses, etc.) contributes to the creation of carpal tunnel syndrome.

Therefore, the prevention of the this syndrome is unusually important. All processes that affect tendon thickening, swelling in the area of the carpal tunnel or its narrowing can lead to increased pressure on the nerve.

Of course, certain systemic diseases (e.g. diabetes, rheumatoid arthritis, endocrine diseases, etc.), tumors, accumulation of fluid in the body as a result of pregnancy or menopause, the taking of certain drugs, etc. should be excluded.

The so-called post-traumatic carpal tunnel syndrome, a condition that arises from the fracture of a thumb bone in a typical site, and has the result, due to changed anatomical conditions, of premature compression of the central nervous system!

Carpal tunnel syndrome occurs more frequently in women. It can occur on both hands, but the symptoms are usually more pronounced in the dominant hand. In carpal tunnel syndrome, its development usually begins as a temporary tingling in the fingers during the night or in the morning, which later becomes present throughout the day. Numbness of the first three fingers of the fist, swelling of the fingers (especially the thumb) and the fist, reduced mobility, and later pain and muscular weakness, are the symptoms of this channelic syndrome.

If the condition progresses, the patients have things falling out of their hands because of muscular weakness, fastening of buttons or a bra becomes difficult and the pain is at that point constant.


Because the clinical image of the carpal tunnel syndrome may overlap with that of the cervical spine, a detailed specialist examination is required.

The diagnosis of carpal tunnel syndrome is based on clinical examination and electromyoneurography (EMNG), which is an electrophysiological examination of the function of muscles and peripheral nerves and may indicate their impairment.

In addition to RTG processing, magnetic resonance imaging can sometimes be done, which detects all changes in soft tissues in the area.


Understandably, the treatment initiated in the early stages of carpal tunnel syndrome provide a better result.

If loss of sensation and atrophy of the muscle of the thumb is present, the patient has a bad medical prognosis. Treatment of carpal tunnel syndrome can be conservative and operative.

Unsuccessfully conservative treatment, often involving corticosteroid injections and splints, results in the need for surgical treatment. The operative procedure is performed under local anesthesia, using the so-called “Pale paths”anesthesia, i.e. a compressive bandage that applies pressure to blood vessels and allows for better visualization during the procedure. The purpose of the surgery is to cut the tunica of the tendon, through which the nerve goes through. The ultimate outcome of surgery depends on the course of the operation, and certainly the experience of the orthopedist or plastic surgeon.

Although performed according to practice rules, only occasionally, after surgery, there is a possibility of reduced finger mobility, reduced sensation, and the possibility of lesser infection.


Post-surgical recovery may take months, depending primarily on the condition of the hand before the surgery itself. A substantial amount of patience is important during this period.

At Ribnjak Polyclinic, you will have complete physical therapy services, as well as modern postoperative treatment with regenerative methods, such as the application of the ACP method, at your disposal.

Using autologous conditioned plasma, healing in the area of the cut is noticeably faster, as well as accelerated decrease of swelling and pain reduction, and rapid increase in the mobility of the fingers is to be expected.

Learn about Autologous Conditioned Plasma (PRP) and its proven benefits in recovery.

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