Carpal tunnel syndrome

Anatomy of the carpal tunnel 

The carpal tunnel is located underneath the wrist crease overlying the wrist joint. The carpal tunnel is really a protective tunnel of bone as well as ligament that protects the anatomical structures such as the median nerve as well as the flexor tendons of the hand (see figure 1). The transverse ligament which overlies the tendons and median nerve is a thick ligament that functions very much like a cable tie and keeps all the flexor tendons as well as the median nerve neatly in place. 

Carpal tunnel syndrome: 

Many critical structures are tightly packed together within a relatively small tunnel. There is therefore significant opportunity for the tunnel to become strained which can affect the structures running in the carpal tunnel. nerve tissue is very sensitive to small changes in pressure which can cause nerve irritation and in turn causes the symptoms of carpal tunnel such as pain in the distribution of the median nerve (see image 1) as well as numbness in this region and it can cause significant weakness as well as wasting of the musculature if more advanced. 

If left untreated compression of the median nerve for longer periods of time can cause lasting nerve damage to the nerve which could lead to ongoing weakness and numbness and pain in the hand. It is therefore important to diagnose this problem early on and to treat it promptly. 


Causes of carpal tunnel syndrome:  

There is still a lot unknown about carpal tunnel syndrome. We know that there are a number of factors that play a role in developing carpal tunnel syndrome.  

This could range from physical repetitive activity to other factors such as diabetes,  hormonal changes such as during pregnancy and it can also be caused by an underactive thyroid. Also a direct injury to wrist can cause damage to the median nerve if and or the wrist joint which in turn can also cause pressure and/or irritation of the median nerve. 


Treatment of carpal tunnel syndrome: 

The correct treatment of carpal tunnel syndrome depends on the accuracy of the diagnosis. The most important way to evaluate the carpal tunnel is simply by doing thorough physical assessment. The Sonoscope ultrasound guided injection clinic has clinical experts with many years of experience in assessing conditions such as carpal tunnel syndrome. Usually this is enough to make a diagnosis. However the use of diagnostic ultrasound provides another level of information and often times confirms the diagnosis made by physical examination. 

The combination of a quick physical examination followed by an immediate review with diagnostic ultrasound and if appropriate and ultrasound guided injection to follow immediately after that sets this clinic apart from many others. The whole package of clinical examination ultrasound diagnostics and injection is all included in the fee there are no hidden extras and all of this can be done within one single session. 

For busy people this is “one stop shop” clinic will deliver the diagnosis and the treatment immediately which will allow people to return their work quickly the

What happens during an ultrasound guided steroid injection for carpal tunnel syndrome  ?

Procedure for carpal tunnel injection ultrasound guided 

The patient is seated with their hand resting on a treatment plinth or a table with the wrist crease facing up to the ceiling. The Injection practitioner has the ultrasound probe with the gel on the wrist crease. He then carefully steers the needle in the path of the ultrasound probe so the needle point can be monitored both for safety and to make sure that the injection is  very accurate. The procedure done ultrasound guided is usually well tolerated and less painful than unguided steroid injections.

The injection uses a steroid  medication. The needle is carefully guided by ultrasound so that the operator can exactly monitor for its accuracy and make sure the injection is deposited in the correct location and is carried out safely.

carpal tunnel syndrome disease

Fig. 1 Diagram of carpal tunnel

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