

Carpal tunnel is a syndrome that affects 5.8% percent of the population, mostly women over 50. Splint, infiltration, surgery… What are the solutions to treat it?
Carpal tunnel syndrome ranks second among occupational diseases. It is also more common in women, for hormonal reasons. From medical treatment to surgery, here are the step-by-step stages of its management.
What are the symptoms of carpal tunnel syndrome?
Most often, carpal tunnel syndrome begins at night. We are awakened in the morning, or even in the second part of the night, by tingling, numbness, sometimes electric shocks, localized in the first three fingers (thumb, index and middle finger) of the hand. The only way to get relief: move your hand in all directions. Sleep quickly disturbed. And, upon awakening, the fingers often remain numb for some time.
“From a few days a week, these symptoms, which can be accompanied by pain that goes up in the forearm, become daily and gradually worsen”, notes Professor Michel Chammas. This is the typical picture of carpal tunnel syndrome.
Where do these tingles come from?
The tingling that can be felt linked to carpal tunnel syndrome comes from a compression of the median nerve stuck at the level of the carpal tunnel, a narrow tunnel enclosed on one side by the bones of the wrist, on the other by a ligament that connects the two edges of the wrist. Since the median nerve controls the sensitivity of the thumb, index, middle and half of the ring finger, it is understandable why the symptoms manifest in these fingers.
When should you consult?
“Generally, people come to see us when the tingling has prevented you from sleeping well for a few weeks,” says Professor Christian Dumontier, surgeon at the CHU Saint-Antoine, in Paris.
Over the months or years, depending on the person, tingling in your fingers can also occur during the day when you are motionless, reading, on the phone… Sometimes, the hand begins to weaken, to become clumsy. In this case, it is time to consult, because the treatment depends on the severity of the syndrome and whether or not you are inconvenienced during the day.
The electromyogram to detect the syndrome
“Only 7 to 8% out of people complaining of ‘tingling’ suffer from real carpal tunnel syndrome”, underlines Professor Dumontier. For the rest, it will be a compression of the cervical nerve, circulatory diseases, damage to the nerve…
To To find out, the rheumatologist or surgeon asks you to detail your symptoms and prescribes an electromyogram (EMG). Thanks to very fine electrode needles (hand and forearm), this examination makes it possible to evaluate the nerve and muscle damage and the place of compression.
But just because it confirms carpal tunnel syndrome doesn’t mean you’ll be operated on. In case of nerve damage and moderate discomfort, a classic treatment will be put in place: splint followed by infiltration.
When should a splint be worn?
The earlier the treatment is put in place, within six months of the first signs, the easier recovery will be. At first, and in case of nocturnal tingling and slight morning numbness, wearing a small standard splint at night is prescribed for several weeks. By keeping the wrist in extension, it thus prevents involuntary flexion movements during sleep, which can increase the pressure in the carpal tunnel and, from there, the pain of the nerve.
“It’s effective, but the intensity and duration of the relief is variable, from a few months to several years,” explains Dr. Vincent Guigal, hand surgeon at the Parc clinic in Lyon. the beginning forms of the disease, and if it improves the symptoms from the first days in 80% of cases, it must continue to be worn for 3 weeks” specifies Pr Michel Chammas, orthopedic surgeon and hand surgeon at the University Hospital of Montpellier . It is reimbursed if prescribed.