How to treat tunnel syndrome?

Author Dr. Tibor Szalontay | 2023.07.06.

Dr. Tibor Szalontay, a specialist hand surgeon at BMM, presented in detail the causes, symptoms and treatment methods of one of the most common hand diseases of our time, tunnel syndrome, in the show entitled Lifestyle Magazine.

The hand tunnel syndrome

Hand tunnel syndrome is a common hand surgical complaint experienced by many. Hand problems make everyday life particularly difficult, as we use our hands in almost every activity. However, pain and limited movement can also prevent us from simply cooking or working. Tunnel syndrome develops in the dominant hand, as one of the main causes is overuse of the hands and wrists. The symptoms are unpleasant but the disease is well controlled.

Tunnel syndrome suspected

Symptoms of tunnel syndrome typically first appear at night. The numbness, tingling and pain interferes with sleep and, over time, symptoms also occur during the day. It is essential to consult a hand surgeon at this stage to avoid further deterioration and surgery. Dr. Tibor Szalontay has been treating his patients for more than 30 years, so he has a lot of experience in treating tunnel syndrome.

It started a couple of weeks ago, I was really hoping it would go away on its own with compresses, colleagues have suggested hand compresses, but the pain won't go away. -says Dr Tibor Szalontay, a patient of Dr Tibor Szalontay with tunnel syndrome.

How is tunnel syndrome diagnosed?

The main cause of tunnel syndrome is the compression of the median nerve in the carotid tunnel. This causes the tingling and numbness and stiff hands.

Dr. Tibor Szalontay performs a thorough examination on his patient and finds that he does indeed have tunnel syndrome. During a test called the Tinel's sign test, the examining instrument is tapped on the palmar surface of the wrist. In tunnel syndrome, the patient will experience a flashing sensation.
This is followed by electrophysiological testing. The ENG test measures the speed at which peripheral nerves conduct stimulation. Where the tendon is pinched off due to tunnel disease, this ability to transmit impulses is reduced.

How can tunnel syndrome be treated?

The effective treatment of tunnel syndrome depends on the stage of the disease the patient is in. In the milder stages, night-time hand splinting and nerve mobilisation physiotherapy may help, as well as physiotherapy treatments such as ultrasound therapy. In the intermediate stage, in addition to these therapies, the hand surgeon may recommend injections of steroids, which should be given every few weeks, three to four times a week.

How is the surgery done?

In the severe stage of tunnel syndrome, surgery, which is a day surgery under local anaesthesia, may be the solution. According to hand surgeon Tibor Szalontay, MD, most patients are looking forward to this surgery, as they live with so much pain.

During the operation, which lasts about 20 minutes, the hand surgeon releases the ligament that holds the nerve down from a small incision. The stitches are removed 10-12 days after the operation, until then the healing wound cannot be exposed to water.

Recovery time depends on how long the nerve has been pinched - the longer the patient has struggled, the slower the return to freedom of movement. This is why it is important to consult an experienced hand surgeon as soon as you notice the first symptoms!