Definition of carpal tunnel syndrome
The term “carpal tunnel syndrome” is used to describe an illness in which the median nerve (nervus medianus) in the area of the wrist is constricted. The carpal tunnel is a narrow space that lies between the carpal bones and the carpal ligament (ligamentum transversum; retinaculum flexorum) above them. The tendons of various muscles as well as the median nerve run through this narrow tunnel.
The typical symptoms of carpal tunnel syndrome are explained by the functions of this nerve. In particular, the sensitivity of the thumb, index finger and middle finger is mediated by this nerve. In addition, the nerve affected by carpal tunnel syndrome serves to control various hand and finger muscles.
Direct damage to this nerve in the course of compression consequently leads to reduced sensitivity, numbness and restricted movement of the fingers. Furthermore, the nightly occurrence of tingling is one of the first signs of carpal tunnel syndrome. In the further course of the disease, the affected patients also develop pain when grasping.
Introduction
Carpal tunnel syndrome is also characterized during pregnancy by damage to the median nerve in the area of the wrist. In general, carpal tunnel syndrome is also one of the most common compression syndromes during pregnancy. Older people are particularly at risk, with women being affected about three to four times more frequently than men.
Since the long-term blockage of the median nerve in the carpal tunnel can cause permanent damage, carpal tunnel syndrome should be treated promptly. As a rule, treatment is also carried out during pregnancy by immobilizing the affected wrist at night. Even this simple measure provides relief for the patient in many cases.
For further therapeutic measures of carpal tunnel syndrome (e.g. local injection of cortisone or surgical splitting of the retinaculum) special guidelines must be considered during pregnancy. The actual cause of carpal tunnel syndrome is an unfavorable relationship between the carpal tunnel and the space actually required by the structures running through it. Due to the limitations of the carpal tunnel, its space is very limited.
If the pressure in the carpal tunnel increases, the vessels and median nerve are compressed. Especially the supply of nutrients and oxygen to the median nerve is strongly impaired in this way. In the long term, this can lead to the individual nerve fibers being damaged and no longer being able to perform their function.
The affected patients experience night-time tingling, loss of sensitivity and pain. The usual risk factors can also contribute to the development of carpal tunnel syndrome during pregnancy. The most important risk factors include Beyond that it can come in the course of the pregnancy by special factors of influence to the emergence of the Karpaltunnelsyndrom.
In this connection above all the hormonal changes play a crucial role. Especially in the last third of the pregnancy the body of the expectant mother tends to store more fluid. This leads to an increased fluid content even within the carpal tunnel.
If the carpal tunnel is relatively narrow due to its individual shape even before pregnancy, the increasing fluid content can lead to the development of carpal tunnel syndrome.
- Congenital narrowing of the carpal tunnel (for example, due to certain variants of a carpal bone)
- Inflammatory processes in the area of the tendon sheaths
- Swelling of the tendon sheaths (particularly frequent during pregnancy, in rheumatic diseases or due to overloading)
- Fractures in the area of the radius or carpal bones
- Arthrosis in the wrist
- Space-consuming processes in the wrist area (e.g. tumors)
Carpal tunnel syndrome usually makes itself felt in pregnancy at the beginning of the disease through pain or tingling fingers. In the early stages, however, these symptoms subside after a short time.
Typical symptoms of carpal tunnel syndrome are pain and tingling paresthesia (tingling fingers), especially during the night. In the further course of the disease, both the duration and the intensity of the pain experienced by the patient increases.In most cases, those affected claim to suffer from pain in the area of the wrist, thumb, index and middle finger, which radiates into the arm. Typically, the discomfort caused by carpal tunnel syndrome can also be relieved during pregnancy by rubbing or shaking the hand.
If the carpal tunnel syndrome is already more advanced, the complaints on the affected hand no longer occur temporarily. Most of the affected patients experience permanent symptoms in the advanced stage. In addition, the pronounced damage to the median nerve can lead to the feeling that the patient has received an electric shock when performing gripping movements.
Furthermore, the functionality of the nerve decreases significantly as carpal tunnel syndrome progresses. The thumb, index finger and parts of the middle finger are usually completely numb (sensitivity disorder). In addition, the patient is typically no longer able to perform fine motor activities with the affected hand. The late stage of carpal tunnel syndrome is also characterized during pregnancy by a significant decrease in the lateral musculature of the ball of the thumb (thumb ball atrophy). This muscular atrophy usually results in a weakness of the thumb in spreading or bending and a resulting loss of strength during grasping movements.
