Tingling in the hands, especially at night, numb fingertips or fingers and hands that have gone to sleep: when the typical symptoms of carpal tunnel syndrome (CTS) begin, those affected should act quickly. If carpal tunnel syndrome is not treated, it can have serious consequences.
About every tenth German citizen knows them Complaints of carpal tunnel syndrome, mostly it starts with a harmless tingling in the hands. Experts estimate that women are affected five times more often than men. As a rule, the problems appear between the ages of 40 and 70, especially at night: you wake up because your hands are tingling, because your hand has gone to sleep again, or there is pain from your hand to your upper arm. After shaking, the pain and tingling go away.
What does tingling in hands have to do with carpal tunnel?
Each arm is supplied by three nerves. They are responsible for the motor system, i.e. the movements, and for the sensors, i.e. the sense of touch and sensation. The middle arm nerve, the median nerve, is responsible for the sense of touch and sensation on the inside of the hand. Motorically it supplies a muscle of the thumb.
This median nerve runs from the shoulder down the upper and lower arm. It runs through what is known as the carpal tunnel on the inside of the wrist. This is a narrow tunnel at wrist level formed by the carpal bones and a tight band of connective tissue. In addition to the finger tendons, the median nerve also runs in this tunnel. The consists of sensory and motor fibers and certain hand muscles that supply fingers and palms.
If this nerve is pressed or even pinched by its surroundings, the symptoms described occur; most patients initially report a harmless tingling in their hands, especially at night. If such an incipient carpal tunnel syndrome is not treated, the nerve can suffer long-term damage.
If the complaints are initially more sensory - the hand can often tingle, for example - motor complaints can later occur, such as reduced strength in the fingers and especially in the thumb. The spectrum ranges from a slight discomfort to permanent paralysis.
What Are the Causes of Carpal Tunnel Syndrome?
In fact, no cause can be identified for the majority of carpal tunnel syndrome. One speaks of an idiopathic (ίδιος means "peculiar" in Greek, πάθος means "suffering") carpal tunnel syndrome.
This form is particularly common in women during the menopause and is attributed to water retention and tissue swelling in the carpal canal. Some people are predestined for carpal tunnel syndrome because they are born with a narrow carpal tunnel. Carpal tunnel syndrome develops when the same hand movement is constantly performed at work, when the wrist is subjected to heavy use, or when the wrist is buckled while sleeping.
Another possible cause is a previous chronic tendonitis or acute inflammation and swelling of the tendon sheaths. Since these are also located in the carpal tunnel, they can press on the nerve. Very rarely, it is a hereditary disease that can affect children. Symptoms can also occur temporarily during pregnancy, because the body stores a lot of water during this time, which can increase the pressure on the median nerve.
Typical symptoms and course of carpal tunnel syndrome at a glance
Most sufferers take them Symptoms of incipient carpal tunnel syndrome not serious enough: What can be bad about it when your hands fall asleep at night?
Carpal tunnel syndrome symptoms are often not taken seriously
However, the longer the nerve remains pinched in the wrist, the more likely it is that there will be permanent nerve damage. Here are the symptoms at a glance:
- Carpal tunnel syndrome often begins with sensory disturbances in the thumb, index and middle finger, as these are supplied by the median nerve. The typical carpal tunnel syndrome symptoms: The fingers feel numb, tingle as if they had "fallen asleep" and hurt.
- These symptoms often occur under stress and during the night. Reason for the nocturnal complaints: Many people unconsciously bend their hand slightly while sleeping.
- In a next step, the symptoms of carpal tunnel syndrome become particularly noticeable when the hand is bent, such as when holding the telephone receiver or the steering wheel in the car.
- As the carpal tunnel syndrome progresses, the discomfort increases, occurs permanently and the pain can radiate into the arm.
- In the advanced stage, the fingers become numb and the muscles of the thenar atrophy, meaning they atrophy.
Carpal tunnel syndrome: the symptoms at first
The most typical sign of carpal tunnel syndrome in the early stages is the fingers falling asleep at night. In the beginning it is enough to move your hand and shake it. If carpal tunnel syndrome is left untreated, the pain increases. These carpal tunnel syndrome symptoms are often accompanied by tingling in the palms of the hands. A dead giveaway that the median arm nerve, which supplies the insides of the thumb, index and middle fingers, and the thumb-side half of the ring finger, is being pinched.
The discomfort usually begins in a single finger and gradually spreads to the other fingers. If this pain first occurs after a strain on the wrist, it later appears suddenly and without any recognizable reason.
Carpal Tunnel Syndrome: The Symptoms in Later Stages
Gradually, the pain moves up into the arm and shoulder. These carpal tunnel syndrome symptoms are accompanied by deterioration in the senses of touch and sensitivity in the fingers. At this stage, it becomes increasingly difficult to button clothing or pick up small objects. Soon the unpleasant sensations in the fingers disappear, instead they become numb. Gradually, a visible dent develops on the ball of the thumb, the ball of the thumb atrophy.
The reason: a muscle in the thumb, which is innervated by the affected nerves, gradually degenerates. Due to the muscle atrophy, the function of the thumb is severely restricted. Because it can no longer be spread apart, those affected find it difficult, for example, to take things in their hands or to grasp a bottle. At this stage, the nerve is already severely damaged. If the therapy is only started at this point, it is often too late, damage to the nerve can no longer be reversed. Loss of feeling in the palm of the hand and paralysis of the thumb can be the consequences.
Carpal Tunnel Syndrome: Do You Have Symptoms on Both Hands?
In carpal tunnel syndrome, the Carpal Tunnel Syndrome Symptoms occurs on both hands in most people, one hand is often affected slightly earlier than the other. Months or years can pass between carpal tunnel syndrome in one arm and the onset of symptoms in the other arm. The right, dominant side is more severely affected in right-handed people and the left in left-handed people. One of the reasons that carpal tunnel syndrome occurs earlier on the dominant side is that it is used more often.
Carpal tunnel syndrome: take the symptoms seriously and treat them!
As with many other diseases, the course of carpal tunnel syndrome can be very different. Many of those affected show moderate symptoms for many years, which are interrupted by long intervals without symptoms. In such cases, there is a particularly high risk. If the early symptoms are not attributed to carpal tunnel syndrome, those affected only go to the doctor when the nerve is irreversibly damaged.