Do you work at the computer for days, trying not to notice the numbness in your hand that has been bothering you for months? Do you sometimes feel sudden, sharp and stinging pain and "lumbago" across your wrist? And sometimes, for no reason at all, is the cramp? These are all symptoms of carpal tunnel syndrome - a painful condition caused by progressive compression of the key nerves in the wrist. So, carpal tunnel syndrome - help yourself - the topic of conversation for today.
What is Carpal Tunnel Syndrome?
This disease is one of the conditions of discomfort caused by the compression of the medial nerve in the carpal tunnel (from the inside of the hand above the fold line). Unpleasant sensations are characterized by the fact that they begin to appear at night on the inner surface of the hands or at the level of the middle finger. Sometimes there are even sleep disorders and everyday fatigue. Often at an initial stage the disease is difficult to recognize, individual symptoms are "written off" for general fatigue
The medial nerve controls the sensations of the palm from the side of the thumb and the fingers (except the little finger). Nerve impulses of a small group of arm muscles, in turn, are responsible for performing more subtle movements. Sometimes the densities resulting from inflammation of the tendons compress the nerves. The pain can be expressed by a sharp numbness in the palm of your hand and often gives into the shoulder. Although these painful sensations can signal other problems in the body, carpal tunnel syndrome is the most common condition of injuries of peripheral nerves in the human body.
Unpleasant sensations and pain can go from hand to finger, forearm, shoulders and back. Often there are swelling and movement disorders. Often, physical activity related to stretching of hands leads to such conditions: cycling, washing hands, some exercises and much more. Strangely enough, but the most frequent reason is not motor activity, but, on the contrary, sitting in one place, namely, at the computer for a long time. When symptoms of carpal tunnel syndrome begin to appear, any questionable activity should be discontinued. Ask your fitness instructor how to properly build further workouts, consult a doctor for a recommendation, but do not try to act on the principle of "help yourself". This is a serious disease that needs to be treated to avoid complications and additional injuries.
Carpal tunnel syndrome is the result of a combination of factors that often lead to increased pressure of the medial nerves and tendons of the wrist of the actual nerve. This disorder has a genetic predisposition - for example, a smaller channel size in some people. Other factors include injury or injury to the wrist and subsequent inflammation, stretching, fracture, hypothyroidism, rheumatoid arthritis, tendon problems, overload, fluid retention during pregnancy or menopause, cysts or carpal tunnel tumors. In some cases, the disease can not be identified.
Symptoms to an exhaustive tunnel syndrome
Symptoms usually appear gradually. First it's numbness, burning or tightness around the palm and fingers, especially between the thumb and forefinger, middle and ring fingers, but never in the region of the little finger. Often patients who experience an exacerbation or numbness in their fingers do not have any more signs of inflammation or loss of sensation. Symptoms can appear first on one or both hands at night, especially if the wrists are bent. To relieve pain and numbness, you can do simple mahi with brushes or massage your brushes against each other. When symptoms worsen, and no measures are taken - symptoms occur more often during the day. The hand is difficult to clench into a fist, a weakness is formed, which prevents very thin movements of the fingers. In the absence of treatment, the area of the thumb can become incompetent, even it will be difficult to distinguish sensations such as cold and heat, sensitivity to pain will be dulled.
When is it time to go to the doctor?
Pay attention to the following features:
- pain in the palm of the hand, giving to the forearm;
- feeling of weakness and helplessness in the hand;
- cold hands - warm forearms;
- loss of strength in the fingers;
- loss of sensitivity in the fingers;
- loss of coordination - you begin to often drop cutlery, glasses, books, etc .;
- puffiness of the index, middle and ring fingers;
- numbness of the thumb;
- loss of fine movements of hands - awkwardness of fingers;
- pain in the shoulders and neck;
- tingling or numbness in the fingers or hands, especially in the area between the thumb and forefinger, middle and ring fingers, but not near the little finger. You notice that when you meet someone, it's hard for you to shake hands with your partner. With the progression of this disease, such weakness and loss of sensitivity can become permanent.
Who is at risk of carpal tunnel syndrome?
Women are three times more likely to suffer from such a disease than men, perhaps because of the small size of the canal. Carpal tunnel syndrome is a very common condition. Approximately 30% of men and 70% of women have experienced this condition at some point in their lives.
The dominant hand is always under threat. In the "risk zone" are also people suffering from diabetes mellitus or other metabolic diseases that affect the nerves directly. This disease, as a rule, is observed in adults and is extremely rare in children.
How to treat?
Treatment of carpal tunnel syndrome should begin as soon as possible (if the first symptoms are detected) and mandatory under the supervision of a doctor. First, you should consider the causes, such as diabetes or arthritis. Primary treatment usually involves resting the affected hand, wrist, respectively, for at least two weeks, during which the patient should not engage in activities that can worsen the condition of the limb. It is often necessary to immobilize the brush with a hard bandage or even gypsum to prevent twisting and bending of the carpal tunnel. And if there is inflammation, cold compresses should be used to relieve pain and swelling.
Non-surgical treatment
Various medications can alleviate the pain and swelling associated with carpal tunnel syndrome. Usually prescribe aspirin and other drugs that can alleviate the symptoms for a relatively short time. Corticosteroids such as prednisone or lidocaine can be injected directly into the wrist or taken orally (prednisolone). They release and eventually eliminate pressure on the medial nerve. Corticosteroids should be used with caution in diabetic patients and people who are predisposed to diabetes, and this creates difficulties in regulating insulin levels. It has been shown that taking vitamin B6 (pyridoxine) can alleviate the symptoms of the syndrome.
Exercises - stretching and strengthening hands, of course, will only be for the good. But they must be performed under the supervision of a physiotherapist, who is specially prepared for this.
Alternative therapy - acupuncture leads to the improvement of some patients, but the long-term effectiveness of this method remains unproven. An exception is yoga, which has been shown to reduce pain and strengthen the tendon among people suffering from long-term pinching.
Surgery
Operative correction of the carpal tunnel is one of the most common surgical procedures in the USA. For some patients, surgical tactics are the only option to return to a normal lifestyle. This issue is recommended to preserve symptoms for at least 6 months. This procedure involves the removal of a part of the tissue that presses the medial nerve and is performed under local anesthesia. Stay in the clinic is only 1 day. Many patients require plastic surgery on both hands. With "open" operations (the traditional approach), a five-centimeter incision is made on the wrist, and then, a cut of the wrist ligaments that extend along the carpal tunnel.
Endoscopic surgery allows to accelerate the flow of intervention and provide a short postoperative period to reduce possible inconveniences. In doing so, two centimeter incisions are made on the wrist and arm, a camera is inserted that looks inside the ligament tissue - and the tendon joints are cut. The whole procedure is observed on the screen.
Although the symptoms subsided almost completely after the operation, a full recovery takes months. In some patients, infection, nerve damage, coarsening of palm tissues and other consequences develop. The subsequent sessions of physiotherapy help to overcome the effect of contraction of the ligament. Most patients recover completely, very rarely symptoms can regress.
Local injections of steroids
Steroid injections are effective enough to temporarily suppress the symptoms of carpal tunnel syndrome - help yourself by studying this simple method. These are not long-term strategies designed to treat patients to improve their lifestyle. This procedure is not suitable for long-term therapy - corticosteroids have their side effects with prolonged admission, at least they begin to lose their strength.
Physiotherapy
There is evidence that the use of physical therapy leads to a steady alleviation of the symptoms of patients with this problem. Most often it is aimed at eliminating the symptoms of chronic pain. Physiotherapy offers several ways to prevent and treat carpal tunnel syndrome. Procedures aimed at pain (symptoms) and dysfunction. Includes a number of procedures - from soft tissue massage and stretching to exercises and techniques to directly stimulate the nerves of the hands. Heating is very effective in this case. In this case, it is necessary to fulfill one condition - complete rest and absence of tension on the hands for at least an hour after the procedure.
A warning
At workplaces from time to time, you need to do stretching exercises and frequent short breaks. Do not engage in activities in which the wrists will be constantly under pressure or somehow overextended. Some people resort to wearing mittens to warm their hands and thus retain their flexibility. But this, as you understand, is not always acceptable. In general, this problem is solved and with the proper approach it is quite possible to get rid of troubles.