Carpal tunnel syndrome – causes, symptoms and treatment options

Does your thumb sleep longer than you do in the morning? Do your fingers tingle after an extensive bike ride? Or do you feel a pain in the first three fingers of your hand? Then come to Dr. Bernard’s practice and let us explain to you in detail how you can treat the Carpal Tunnel Syndrome can treat. However, you can already obtain initial information.

The carpal tunnel is a type of tube that extends from the forearm to the carpus and, similar to a household cord, some important nerves and vessels inside, which are necessary for the use and supply of the hand. Of central importance for this is the Median nerve, which is crucial for the sensation of the thumb, index and middle finger and for the control of the same.

Carpal tunnel syndrome manifests as a narrowing of the supply tunnel. This narrowing pinches the median nerve and severely impairs its function.


In most cases, the anatomic bottleneck is caused by a genetic disposition underlying. Pregnancy, rheumatic diseases and other exceptional physical conditions., which affect the connective tissue, can also cause carpal tunnel syndrome. Likewise, this also applies to changes in the bone caused by poorly healed fractures and arthrosis or also for Diabetes. Mechanical activities at the daily level are not determining factors for carpal tunnel syndrome.


Initially, the symptoms appear every now and then during higher stress. Reasons for this can be, for example, a bent hand during sleep or the one-sided posture of the hand after a long bicycle ride. The deficient supply of the median nerve manifests itself in Numbness in thumb, index and middle finger, Tingling and Feeling of weakness during e.g. grasping movements. These symptoms, which initially occur only acutely and quickly subside again, can become a permanent state of insensitivity and functional impairment if they are not treated. This can lead to further complications, such as complete numbness of the fingers or muscle damage of the thumb (Thumb Ball Atrophy) and resulting in a significant loss of strength during grasping movements.


Carpal tunnel syndrome is diagnosed in three steps:

  1. An objective functional examination of the hand and fingers, simple tests in terms of Sensory disturbances Or Stress Symptoms (a transient discomfort following severe wrist flexion) are used to determine whether or not carpal tunnel syndrome is present.
  2. Electrophysiological examinations can be performed on the basis of the Nerve conduction velocity clarify to what extent the median nerve has already been affected.
  3. Lastly, if not already known, the Cause of the carpal tunnel syndrome must be clarified. This is important for the subsequent treatment.

Treating carpal tunnel syndrome

If carpal tunnel syndrome is a byproduct of pregnancy, a wrist splint should be sufficient to reduce the stress on the median nerve. In similarly acute situations, medications such as cortisone or even ultrasound waves can lead to an improvement in the symptoms. However, this should always be used in consultation with the attending physician.

In a chronic condition, however, surgical intervention is mandatory. This involves making a skin incision on the inside of the hand and cutting the underlying connective tissue ligament so that blood flow is restored inside the supply tube and neither nerves nor vessels are constricted.

The entire procedure takes only a few minutes and can be performed under local anesthesia. A light Compression bandage should be worn for several days. The usual sparing and hygiene recommendations after operations with open wounds apply.

In the best case, the discomfort and restrictions disappear immediately after removal of the bottleneck. Depending on how much nerves and muscles have already suffered, the recovery phase may take a longer time and may need to be supported by physiotherapy exercises.

Immediately after surgery, hand restriction can be expected for a few days to a few weeks. A reduction in strength of the coarse grasp may persist for several months.

However, it is worth it. In interviews and in numerous videos, Dr. Bernard repeatedly emphasizes how much she cares about a harmonious whole. This also includes the functional efficiency of each individual part of the “Total work of art man”.