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Nerven compressions syndromes
Through disease or putting weight on nerves they can be constricted (squeezed or crushed) in their anatomical run. This usually occurs at certain narrow points. This nerve compression then leads to a worsening function of the nerve. The impulse coming from the spinal cord cannot be passed on to the muscle and the signal deriving from a touch to the skin cannot be passed back to the nerve cell in the spinal cord.
Nerve compression syndromes are rather common and should be operated on if they do not disappear after not putting any pressure on them and taking care of them for 4 - 6 weeks. It is usually necessary to have the speed of transmission by the nerves measured previously by a neurologist and, if possible, also to display the muscle function.
On the grounds of our vast experience in this field, our department is able to treat all compression syndromes, even very rare ones e.g. Tarsal Tunnel Syndrome where the tibial nerve is constricted in the region of the inner ankle.
The two most common compression syndromes are outlined in the following. Compression of the median nerve - Carpal Tunnel Syndrome
The median nerve, which supplies the thumb side of the hand, runs through a narrow channel (carpal tunnel) in the region of the wrist. This nerve can be constricted by pressure resulting from the swelling of the surrounding tissue. Typical symptoms for this constriction are temporary paralysis of the thumb, first and middle finger, and pain which occurs especially at night time and is strong enough to wake one up but can be reduced by shaking the hand. Elderly people mainly suffer from carpal tunnel syndrome. Women are affected more often through the hormonal changes during pregnancy or the menopause. Diabetes can also increase the risk of developing carpal tunnel syndrome. If the above mentioned symptoms have already occurred, a neurologist makes a special examination to determine the functioning of the nerve. An operation needs to take place if the pain is persistent. In this operation the narrow channel is opened and the nerve is given enough space again to function properly. This can be done under local anaesthetic and only in difficult cases has to be done under general anaesthetic or anaesthetic of the arm. After the operation a splint is put on for 10 days to achieve optimum wound healing.
Important information: Carpal Tunnel Syndrome
Stay at the clinic: out-patient, when accompanied by severe effects or repeated operations in the same region, 1 - 2 days in-patient
Duration of operation: 15 - 30 minutes
Type of anaesthesia: local anaesthetic, arm anaesthetic or general anaesthetic
Follow up treatment: Immobilisation in a splint for 10 days
Risks: haematoma, swelling, pain. When condition is long-standing the symptoms will not disappear immediately.
Final result: The hand can be used as normal again after about 4 weeks. Compression of the ulnar nerve - Sulcus Ulnaris Syndrome
The ulnar nerve runs on the inside of the elbow, at the so called "funny bone". In this place a narrowing of the nerve can take place as a result of a growth or other condition. A numb feeling, mainly of the little finger and the side of the hand, is a symptom; the back of the hand can also be affected. In advanced stages the muscles of the hand have shrunk and the hand is weak in general. An operation is performed to expose the nerve under a microscope and if necessary it is placed on the bending side so that it is not stretched with every movement of the elbow. Afterwards the arm is rested in a splint for 10 days to ensure good wound healing.
Important information: Sulcus Ulnaris Syndrome
Stay at the clinic: out-patient, when accompanied by severe effects or repeated operations in the same region, 1 - 2 days in-patient
Duration of operation: 30 minutes
Type of anaesthesia: local anaesthetic, arm anaesthetic or general anaesthetic
Follow up treatment: Immobilisation in a splint for 10 days
Risks: haematoma, swelling, pain. When condition is long-standing the symptoms will not disappear immediately.
Final result: The hand can be used as normal again after about 4 weeks