CARPAL TUNNEL SYNDROME, GENERALITIES, MANAGEMENT AND TREATMENT

Abstract

Introduction: Carpal tunnel syndrome (CTS), also called median wrist mononeuropathy, is the most frequent nerve compression syndrome reaching up to 90%.

Objective: To detail the current information related to carpal tunnel syndrome and its management, as well as to analyze the conservative and surgical treatment of this disease.

Methodology: A total of 27 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 18 bibliographies were used because the other 9 articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: túnel carpiano, síndrome do túnel do carpo e AINEs, carpal tunnel syndrome, treatment in patients with carpal tunnel syndrome and corticoids in carpal tunnel.

Results: Wrist flexion and extension increase pressure in the carpal canal, leading to the following symptoms: pain, numbness and paresthesia. Corticosteroid injections are recommended in mild to moderate carpal tunnel syndrome. Endoscopic carpal tunnel release has less postoperative pain, earlier recovery in grip and pinch strength, compared to open release. Postoperative complications are infrequent and most are minimal and transient.

Conclusions: Carpal tunnel syndrome is the oppression of the median nerve at the level of the wrist joint, which may be accompanied with limitation in epineural and axoplasmic blood flow, leading to nerve dysfunction, edema, and scarring. The diagnosis of carpal tunnel syndrome has been made through a mixture of clinical history and physical examination maneuvers, however, the use of ultrasound and electrodiagnostic tests is now being supported. There are conservative and surgical treatments, among which evidence shows that steroid injection and carpal tunnel release are effective and present good treatment results.