Tunnel wrist syndrome( often synonymous terms are used: carpal tunnel syndrome, carpal tunnel syndrome)?a set of symptomatic manifestations, such as weakness of the hand, numbness of the fingers, and others caused by the squeezing of the nerve passing through the wrist canal( the so-called median nerve).
Clinic of the disease
This syndrome is one of the most "popular" types of tunnel syndromes. Under the latter, it is customary to understand the symptoms that result from the constriction of the nerve passing through the anatomical canal( tunnel).
Such channels are formed by closely located bones, muscles and tendons.
In a normal state, the vessels and nerves freely pass through the canal. If some pathology develops, the tunnel becomes narrower, putting pressure on the nerve.
The carpal tunnel is formed by the bones of the wrist from the sides and from below, and from the top - by the transverse ligament. The tendon and the median nerve pass through it. This nerve guides the sensitive branches to the 1st, 2nd and 3rd fingers, and also to the half of the 4th, and the motor ones to the muscles of the 1st finger.
In addition, during pregnancy, lactation, when the connective tissue loosens and the propensity to edema increases, the probability of developing pathology increases. Likewise, hormonal disorders, provoked by menopause or the use of birth control pills, provoke a tunnel syndrome.
Statistical data is constantly changing due to the gradual transition of the disease to the category of occupational pathologies.
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Causes of Tunnel Syndrome
To date, it has not been established reliably why the pathology develops.
But the factors that provoke nerve compression in the wrist tunnel are:
- edema and stretch caused by trauma;
- microtrauma that occurs in individuals whose activities involve frequent repeated repetitive motions( work on the computer) or chronic effects on the wrist( construction work);
- pathologies and special conditions of the body, in which there is a metabolic disorder, deformation changes in the tissues of the canal and tendons, development of edema( pregnancy, diabetes, bony outgrowths, hypothyroidism, rheumatoid arthritis and others);
- tumor formation of the nerve passing through the canal, or localized in the carpal region( schwannoma, lipoma, neurofibroma, hemangioma and others);
- smoking( due to violation of blood supply);
- obesity.
Symptoms of
The syndrome has the following symptoms( first appear only during work and later in rest):
- numbness of the fingers( mainly at night and only the 3rd, 2nd and 1st and half of the 4th);
- painful sensations;Tingling
- ;
- "goose bumps";
- sensation of weakness of the hand.
Muscle, whose functioning is determined by the median nerve, is later affected, and
- appears as a weakness;
- atrophy;
- other movement disorders.
Sometimes these symptoms also spread to the rest of the arm( forearm, shoulder and farther).
Diagnosis
Diagnosis is confirmed by the tests:
- Tinnel - when you tap your wrist in a certain area, a tingling or painful piercing appears in your fingers;
- Durkana - when wrist compression develops symptoms, as in the previous test;
- Fahlen - with the raising of hands, which increases the pressure in the carpal tunnel, the symptoms intensify;
- oppositional breakdown - difficulties with the combination of the little finger with the thumb in the development of pathology;
- shaking reduces the manifestation of symptoms in the early stages;
- electrodiagnostics( determine how fast the nerve is pulsed).
Differential Diagnosis
Tunnel carpal syndrome requires differentiation with:
- diabetic polyneuropathy;
- by arthritis;
- cervical radiculopathy.
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Treatment of tunnel wrist syndrome
Therapeutic treatment is as follows:
- Applying cold, reducing the load - with mild manifestations of the syndrome.
- Fixation in the physiological position of the wrist by means of ointments( special devices) and tires.
- Admission of non-steroidal anti-inflammatory drugs( based on ibuprofen, nimesulide, etc.).
- Local administration of hydrocortisone.
- Systemic reception by a short course of glucocorticoids.
- Electrophoresis with analgesics and corticosteroids.
- Surgical intervention in severe cases or with the preservation of symptoms for more than half a year - decompression( elimination of compression) of the carpal canal by dissection, partially or completely, of the transverse ligament. Methods of endoscopic surgery.
The following methods can help with this pathology, but have dubious evidence of efficacy:
- exercises for the brush;
- massage;
- mobilization techniques.
The folk remedies for help to relieve symptoms of the disease for a while, but require compulsory preliminary consultation with a doctor:
- application for removing the edema of leaves of cabbage, plantain;
- use for hands of contrasting trays;
- rubbing the wrist with a mixture of black pepper and vegetable oil;
- drinking diuretic teas.
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Prognosis and prevention of
The absence of treatment over a long period of time leads to irreversible changes in the median nerve. A complete loss of motor and sensory functions is possible.
As a preventive measure, doctors recommend:
- Quitting smoking.
- Regular exercise.
- Weight optimization.
- Work on ergonomic equipment.
- Timely therapy of wrist and joint pathologies( arthritis, etc.).
Thus, carpal tunnel syndrome, caused by compression of the median nerve and manifested by impaired sensitiveness and motor activity of the fingers( with the exception of the little finger), can be treated successfully if the illness is not started and the doctor is on time to pay a visit.