Strangely, despite many excellent design elements, there seem to be a few significant flaws in the human body.
The one the troubles me the most at my age, is that at 40, there seems to be a use-by-date on a number of structures. The most obvious is the lack of eggs for reproduction, but this awful affliction also affects the musculoskeletal (bone and joint) system.
The tendons which flex the fingers are secured to the bone by a number of bridges which are known as pulleys. Unfortunately with age, and diabetes, these tendons swell. They then rub on the bridges and form a perfect storm of inflammation. Eventually the tendon is so swollen that the patient can pull them through the bridge but without using the other hand, they can't straighten them. With the application of force, they 'pop' back - sometimes accompanied by severe pain! Quite a strange state of affairs if you think about it.
The treatment options include:
1. Anti-inflammatories - useful in a mild case
2. Splint - by preventing flexion of the finger, then it can't get trapped
3. Steroids - these may be very useful if the swelling is still quite soft and pliable
4. Surgery - by releasing the bridge over the tendon, it is once again, able to move. This is done under local anaesthetic as a day surgery procedure.
:Patients are often labelled Carpal Tunnel Syndrome and it becomes a grab-bag for anyone complaining of anything to do with their hand. Well-meaning friends will tell stories about surgery and the success or otherwise.
Carpal Tunnel Syndrome (CTS) is a very specific condition. The median nerve (which usually supplies sensation to the thumb, index, middle and half of the ring finger) is crushed by pressure from swollen tendons at the level of the wrist joint. While this can sound a bit severe, it doesn't take much swelling to irritate the nerve. As such, when the nerve is irritated, it fires off pins and needles and eventually numbness information to the brain. This usually wakes you at night, forcing you to hang the hand over the side of the bed or shake it. While CTS itself is not always a problem, the sleep deprivation can be significant.
The treatment options are:
1. Splint (worn at night and prevents curling your wrists during the night)
2. Steroids (this has varying success, but some think it is worth a try)
3. Surgery Obviously the surgeon is most familiar with the surgery and can discuss it with you. It is up to you which option you take, but if your thumb muscle is getting weak, then you should seriously contemplate surgery.
Orthopaedic Surgeon in Cairns, Far North Queensland