Sudden awakening at night? Time to watch your wrists

Such painful condition develops due to the compression of the median nerve of the hand at the level of wrist, according to Dr Saleh Mohammed Kagzi, Orthopaedics Surgeon at Zulekha Hospital, Dubai.

“This occurs most often in women between the ages of 30 to 60 years,” he said. “Physically inactive, older as well as obese or overweight patients are most likely to develop this problem. Pregnant women as well as women at menopause are also most likely to develop such syndrome.”

The cause of this syndrome is the compression of the median nerve at wrist due to the overcrowding in the space occupied usually by the nerve. For example swelling from infection, or injury, tumors, ganglion, lipoma etc

Systemic conditions like obesity, alcoholism, diabetes mellitus, and thyroid dysfunctions are other causes. Occasionally, sleeping posture at night when wrist is kept in bent position for long hours can also result in this syndrome.

Labourers using vibrating machinery are at risk as are office workers, especially typists and data entry clerks who spend long hours with wrist flexed.

Clinically this condition is identified because of its peculiar symptoms which wake the person from deep sleep and relief is only after moving the wrist. Diagnosis of the condition is mostly clinical but sometimes confirmatory tests like nerve conduction or MRI of the wrist is required. Simple X-rays may be required if a bone related disease or malunited fracture of the radius is suspected as the cause.

This syndrome should be carefully differentiated from other conditions with similar symptoms like cervical spondylosis, thoracic outlet syndrome, or median nerve compression at the higher level. Treatment starts with the precautionary measures which include prevention of the risk factors and reductions of the compression on the median nerve by avoiding frequent bending of the wrist.

Medications like analgesics, and splinting of the wrist particularly at night can greatly relieve the symptoms. In advanced stage or chronic neglected cases surgery may be required to release the carpal tunnel.

If the condition is not treated adequately it may result in permanent damage to the nerve of the hand and results in loss of muscle power – hand grip weakness, thinning of the hand.

In order to have complete cure it is very essential to not only diagnose the condition but also to recognise or not to overlook the associated factors which will also require treatment for eg diabetes, overweight, thyroid disorders, alcoholism, obesity, ganglion and inflammatory diseases like gout, rheumatoid arthritis.

--—news@khaleejtimes.com

Dr Saleh Mohammed Kagzi, Orthopaedics Surgeon at Zulekha Hospital, Dubai