Tunnel syndrome
Tunnel syndrome
Tunnel syndrome occurs when a peripheral nerve is pressurised by the surrounding muscles, tendons or bony canals. The tunnel syndromes can have a number of causes:
- Injury, fracture, or inflammation can cause the surrounding nerves to compress
- Scarring and bone growth can also narrow the diameter of the canal
- It can also be caused by various diseases: diabetes, hypothyroidism, rheumatoid arthritis, gout
- Overexertion of the affected limb, regular to irregular use
Several forms are distinguished from tunnel syndromes. They have in common well-defined symptoms. The leading complaint of tunnel syndromes is pain, which mainly occurs at night. Initially only unpleasant numbing is felt in the limb, which occurs first at night, then increases during the day. The uncomfortable, disturbing numbness is caused by the compression of the surrounding (peripheral) nerves that surround the affected part of the body. These nerves often run in a canal surrounded by tendon, muscle or bone. These channels are called tunnels, and if the nerves running through them are compressed, we talk about tunnel syndrome.
After a longer period of time, you will experience loss of sensation, sharp pain and a burning sensation that will not go away. If not diagnosed in time, tunnel syndrome leads to muscle weakness, which causes the limb muscles to atrophy.
Some types of tunnel syndromes
Carpal tunnel syndrome
Carpal Tunnel Syndrome is when the nerve that innervates the flexor muscles of the forearm and several small hand muscles at the level of the wrist is compressed by the surrounding muscles, tendons and bony canals. The condition can occur as an occupational hazard when the wrist or forearm is overused or when the fingers are used regularly and monotonously (computer keyboard and mouse too much), excessive physical stress on the hands and wrists (lifting heavy weights), which causes tingling, numbness at the ends of the thumb, index and middle fingers, followed by paraesthesia, sensory disturbance and loss of tactile sensitivity. The wrist is usually sensitive to pressure and the pain increases when the wrist is moved, especially when it is bent backwards, often radiating into the forearm. In the early stages of the disease, good results can be expected from conservative treatment. If the patient's symptoms do not improve despite conservative treatment, the last resort is surgery, after which, if the muscle atrophy has not been marked, muscle strength will soon return.
Cubital tunnel syndrome
Elbow tunnel syndrome most commonly develops in athletes and people who do heavy physical work. In most cases, an elbow injury or joint problem is the cause of the syndrome. Elbows, a lot of writing or excessive use of mobile phones can also cause the peripheral nerves to become suppressed. Numbness mainly occurs in the ring finger and little finger, palm, especially at night. The unpleasant numbness is accompanied by a burning pain that can radiate into the forearm. The affected hand is often clumsy, making it difficult to make fine movements and bending the little finger. If the disease is not diagnosed in time, the muscles inside the hand may atrophy.
Guyon Tunnel Syndrome
If one of the branches of the ulnar nerve in the forearm is under pressure, this is called Guyon's tunnel syndrome. The main symptoms are numbness in the ring and little finger, which can radiate into the forearm. The muscles of the fingers may also weaken and muscle atrophy may develop.
The reasons for its development may be:
- Demanding physical work
- Fracture of the ulna
- Prolonged pressure on the little toe pad (e.g. crutching, cycling)
Treatment of tunnel syndrome
If other diseases (diabetes, hypothyroidism, rheumatoid arthritis, gout) are causing the symptoms, the primary disease should be treated and eliminated. We can treat the affected area Kinezio Tape-pel, which reduces inflammation and pain. The patch can last for several days and, because it is flexible, it does not prevent the patient from moving. Inflammation can be reduced with non-steroidal anti-inflammatory drugs and ointments. Physiotherapy and physiotherapy can improve the condition of a painful limb. One of the most effective physiotherapy techniques is Peripheral nerve mobilisation. The method involves releasing the pressure on the pinched, blocked peripheral nerves. The treatment reduces pain and sensory disturbance in the affected area and restores function to the limb. If conservative treatments do not help, surgery is required. The surgery involves releasing the nerve from compression in a day surgery.
Investigation: Hand surgeon, orthopaedic-, or rheumatologist specialist.
Therapy: specialist in hand surgery, orthopaedic specialist, rheumatologist specialist, physiotherapist-physiotherapist
Our hand specialists
Dr. János Bartha
Orthopaedic-traumatologist, robotic surgeon
Dr. György Kocsis PhD
Orthopaedic traumatologist, hand surgeon, assistant professor, wrist, elbow and shoulder surgeon, upper limb specialist
