NIGHT PAIN AND TINGLING: FIRST SIGNS OF THE CARPAL TUNNEL SYNDROME

The carpal tunnel syndrome is a frequent disease, especially among the women in pre- or post menopausal age provoked by repeated job activities, traumas, microtraumas and hormone alterations. Which are the symptoms to identify this pathology?

The carpal tunnel syndrome presents three phases. The first, defined “soft paresthetic” is characterized by tingling in fingers, thumb, index and half ring finger at the time of awakening, the symptoms are bland, but defined and bothersome, and increase by using work tools as, for example, the mouse and repeated activities. The second phase, known as “irritative”, reveals itself over the months, when the tingling is ignored. The suffering increases and the neuropathic pain combined with tingling appears, especially during the night by forcing the patient to continuous awakenings, and is not possible to control it with antinflammatories. “In this phase is possible to use infiltrations, specific drugs and split, namely personalized orthesis – as Alberto Donadelli, MD, orthopaedic surgeon, specialized in hand, wrist and elbow surgery explains -. In this phase, after the neurological test, electromyography (EMG) and nerve ultrasound, often people think of decompression operation solving the problem and avoiding the paralytic phase”.

Indeed, if the operation is not executed at this point of the problem, it comes to the third phase, defined paralytic. “At this point the nerve loses definitively its features – MD Donadelli tells -. The sensory threshold begins to drop with loss of touch, the thumb musculature loses tone and in most serious cases we can reach a complete motor-sensory paralysis until the pain is resolved, but with a serious sensory and movement deficit of thumb. In this phase often the operation solves the pain problem, but doesn’t help restore the sensitivity”.