Kurt Z.: “My wife had car­pal tun­nel sur­gery on both si­des a few weeks ago. While the wound pain is sub­si­ding, she still lacks strength in her hands. Most no­ta­bly, she has no sen­sa­tion in her fin­ger­tips, which is ne­ces­sary for pi­cking up small ob­jects like pills. What can one do to help ac­ti­vate the ner­ves in the fin­ger­tips? Which spe­cia­list can help, and how long might this con­di­tion last?”

As­so­ciate Pro­fes­sor Dr. Dr. Ma­xi­mi­lian Kas­pa­rek: The sym­ptoms de­scri­bed sug­gest a very pro­no­un­ced car­pal tun­nel syn­drome. This in­vol­ves a com­pres­sion of the so-cal­led me­dian nerve, which runs th­rough the car­pal tun­nel on the flexor side of the hand. This tun­nel is boun­ded by the car­pal bo­nes and co­vered by a strong li­ga­ment. Du­ring the ope­ra­tion, this li­ga­ment is com­ple­tely se­vered. The cau­ses are not fully un­ders­tood. Pos­si­ble trig­gers in­clude in­ju­ries, in­flamm­a­ti­ons, rheu­ma­tic con­di­ti­ons, and dia­be­tes. Ty­pi­cal sym­ptoms in­clude sen­sory dis­tur­ban­ces in the fin­gers and bur­ning or elec­tric-shock-like pain. Mus­cle func­tion is also impaired.

Af­ter the ope­ra­tion, the pain sym­ptoms im­prove first. Only la­ter do sen­sa­tion and strength re­turn. It can take up to six months for the nerve to re­co­ver from the com­pres­sion. Ho­we­ver, mus­cle atro­phy may so­me­ti­mes persist.

The­r­e­fore, in case of sym­ptoms, I re­com­mend a prompt spe­cia­list ex­ami­na­tion (e.g., by an or­tho­pe­dist). Sur­gery should not be de­layed to pre­vent per­ma­nent da­mage. In­ten­sive tre­at­ment of the af­fec­ted hand is im­portant af­ter a sur­gi­cal pro­ce­dure. Ide­ally, this should be done un­der pro­fes­sio­nal gui­dance as part of oc­cu­pa­tio­nal the­rapy to sup­port nerve healing.