Tunnel syndrome or carpal tunnel syndrome is a neuralgic disease. Included in the group of tunnel neuropathies. It manifests itself as prolonged pain and numbness of the fingers. The most common cause is prolonged compression of the median nerve between the bones and tendons of the wrist.

It occurs much more often in women than in men. The consequence of the manifestation of pain is a pinched nerve, which, in turn, can be caused by a thickening of the tendons that run very close to the nerve, as well as thickening or swelling of the nerve itself. This occurs as a result of constant stress on the same wrist muscles. Often the first ones arise discomfort when using a computer mouse for a long time, when the hand is in a suspended state.

In cases where a person is engaged in office work for a long time or in activities that place a lot of pressure on the wrists, the disease can cause a complication in the form of cubital tunnel syndrome.

Etiology

In fact, any condition or process that reduces the size of the carpal tunnel or increases the volume of tissue within the tunnel itself can cause the symptoms of carpal tunnel syndrome. The most common causes are wrist sprains, dislocations and fractures. In addition, the causes may be:

• pregnancy. During this period, too much fluid accumulates in the body, which leads to swelling;
• . A person develops problems with nerve fibers if this disease progresses;
• changes in the functioning of the thyroid gland, in the case of extraction of half or all of the gland. The person begins to gain weight, which increases pressure on the wrist. Changes in hormonal levels also adversely affect nerve fibers.

If a person has any of the above problems, then he will experience unpleasant and tingling sensations when:

• prolonged use of force;
• uncomfortable body position;
• incorrect positioning or support of the wrists;
• repeating the same actions with your hands;
• elevated body temperature;
• prolonged vibration (for example, when traveling by car or bus);
• keeping the wrist suspended for a long time (working at a computer).

All of the above factors can trigger progression serious problems. In addition, drinking alcohol, smoking or obesity can worsen the situation.

Also, the causes of occurrence can be processes in the body, such as:

• hormonal disbalance;
• hereditary predisposition;
• age category;
• infections and fractures.

Symptoms

Early in progression carpal tunnel syndrome manifested by trembling, itching and slight tingling. Some symptoms may appear much later, after the end of any active action wrist. The late stage of the disease is characterized by significant numbness, pain and heaviness in the hands, sensitivity in the hands decreases, and a tingling sensation in the fingers increases, which becomes unpleasant and irritating.

Often, people with carpal tunnel syndrome experience insomnia, which is associated with pain and cramps in the hand. With the most advanced syndrome, muscle atrophy is observed, the person can no longer clench his hand into a fist. His hands and arms stop “obeying” him. People exposed to the symptoms of the syndrome lose the ability to lift heavy things or use mobile phone, read a book by weight, long time devote more than 15 minutes to working on a PC, and sit behind the wheel of a car. They also have problems with fine motor skills.

Doctors note that the symptoms of the syndrome often appear during sleep. In any case, on initial stage the symptoms are temporary; changing the position of the hands and shaking them helps to get rid of the discomfort. On late stages progression pathological process Such measures are not effective and do not eliminate discomfort.

Diagnostics

The patient himself will not be able to diagnose carpal tunnel syndrome, since the average person will not be able to distinguish the usual short-term numbness from the painful syndrome. Therefore, you should visit a highly qualified specialist.

At the appointment, the doctor will conduct a full examination and prescribe appropriate tests (may vary depending on the reason for the discomfort). During the examination, the doctor has the opportunity to identify:

• numbness of the entire palm or some fingers - thumb, index, middle and partially ring fingers. The little finger remains unaffected, which can be an important factor for specialists in making a diagnosis;
• swaying over the affected area. There is also a sharp manifestation of tingling in the fingertips;
• the maximum degree of wrist flexion for one minute leads to complete numbness, colic or weakening of the hand muscles;

For additional diagnostic purposes, doctors may use a small current to determine the speed of nerve conduction. They also resort to x-ray examination, which makes it possible to exclude other diseases or inflammatory processes.

Treatment

Treatment for carpal tunnel syndrome is possible in several ways. The choice of one of them directly depends on the stage and symptoms of inflammation of the nerve fiber. Treatment may be:

• independent, but based on the doctor’s recommendations. Usually used in the simplest cases (on early stage). To do this, use warming ointments and a fixing bandage for the wrist. It helps relieve symptoms while a person sleeps and also helps them disappear completely. TO independent methods treatment can also include a change in working conditions;
• medicinal. The simplest anti-inflammatory drugs will help reduce pain and discomfort. Steroid injections have their place, but are only temporary. Some simple wrist exercises will give additional benefits;
• contacting a physiotherapist. The treatment that he can offer on his part consists of optimizing the patient’s workplace, advising on the correct position of the body at work in general and the wrist in particular. Will give advice on what physical exercises should be performed to relieve symptoms and suggest methods of prevention;
• surgical intervention. Such a radical method of treatment is resorted to only in the case of the most advanced symptoms, when a person cannot perform practically any movements with his hand. Open surgery involves making a small incision in the transverse carpal ligament, after which the skin is sutured and the ligaments are left separated. This is an operation simple type, after which the patient can go home on the same day. Symptoms of carpal tunnel syndrome are minimized immediately after surgery. But full recovery may take from a month to a year, depending on the stage of development of the syndrome.

Prevention

IN modern society A huge number of people spend most of the day at the computer. Therefore, the main preventive method is the correct arrangement of things in the workplace where the computer and keyboard are located. It follows from this that the main measure to prevent the occurrence of the syndrome is to adjust the height of the chair in relation to the table, which, in turn, depends on the person’s height. A work chair must have armrests. A special (or perhaps homemade) wrist rest has a positive effect. It is also important to give your joints a break for at least 1-2 minutes per hour of working on equipment.

The most effective method To prevent carpal tunnel syndrome, light hand exercises are considered. Exercises are performed 10 times on each hand:

• clench your hand tightly into a fist and with the same force open your palm as wide as possible;
• rotational movements of each finger clockwise and counterclockwise;
• clench your hands into a fist and perform circular movements with your wrist in all directions;
• bring your palms together, then move all your fingers as far as possible, and then cross them forcefully;
• put your palms together, pressing tightly, and move each pair of fingers in turn;
• Cross your fingers in a lock, both palms are horizontal. Bend your fingers down, thereby raising your wrists up;
• alternately connect the pad of the thumb with all fingers on the hand;
• join your palms in front of your chest and, without unclenching them, slowly lower your hands below waist level, and then return to the starting position;
• Position your palms as in the point above and squeeze them with force.

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Diseases with similar symptoms:

Scalenus syndrome is a set of symptoms that result from compression of nerves or blood vessels due to deformities in the scalene muscle. It manifests itself as pain, numbness and weakness in the neck, shoulder or arm.

Apathy is what it is mental disorder, in which a person does not show interest in work, any activities, does not want to do anything and, in general, is indifferent to life. This condition very often comes into a person’s life unnoticed, since it does not manifest itself as painful symptoms - a person may simply not notice deviations in mood, since the causes of apathy can be absolutely any life process, and most often a combination of them.

Wilson-Konovalov disease is a hereditary pathology that is characterized by a disorder of copper metabolism in the human body. Wherein this element tends to accumulate in various organs, leading to disruption of their functioning. This pathology affects both men and women. But representatives of the stronger sex suffer from it 4 times more often. The progression of the disease does not depend on lifestyle and place of residence. In the medical literature, this condition is also called hepatocerebral dystrophy or hepatolenticular degeneration.

Perhaps from time to time you experience itching and slight pain in the wrist area, which is accompanied by a feeling of weakness in the hand,- as if you had lost control over her. These symptoms do not occur in all people, but if you encounter them and, especially, if they become chronic, it is very unpleasant, since you cannot use your arm to the fullest, and the pain sooner or later becomes unbearable. Today we will talk about carpal tunnel syndrome.

What can you do if you are among the unfortunate ones who experience these symptoms? Is surgery really the only way out? There is no remedy, no medicine to get rid of this disease?

Traditional medicine, as a rule, likes to treat any anatomical disease with the help of surgeons. If an engine part breaks in a car, mechanics these days ask the manufacturer for a new part and replace it. It seems that there are no good mechanics anymore, unless they are specialists in replacing parts. It seems, unfortunately, that a similar situation is developing in medicine.

But maybe there is another way out? We will try to explain the causes, symptoms and talk about treatment options (both “conventional” and alternative) for this unpleasant disease.

What is carpal tunnel syndrome?

The carpal tunnel (also known as the carpal tunnel) is a narrow space in the wrist through which the finger flexor tendons and the median nerve, one of the most important parts of the hand, pass. The canal is already very narrow, but for a number of reasons it can narrow even more, which will lead to pinching of the nerve. A pinched nerve will not be able to function fully.

Pressure on median nerve leads to a change in the sensitivity of the hand and loss of the ability to move it. This may be expressed in a sensation of itching, or perhaps in a sensation quite a lot of pain. Simultaneously with pain or itching, weakness appears, and the sick person cannot control his hand, primarily the large and index fingers.

This occurs because the muscles do not receive the necessary impulses from the median nerve. Over time, muscles can “forget” how to move and the handshake of a person suffering from carpal tunnel syndrome will become very weak.

Causes

We have already said that the place where the median nerve connects to the hand is called the carpal tunnel. This channel is very narrow and because of the slightest inflammation the nerve may become pinched. When a nerve is pinched, you feel pain, itching, numbness or weakness. This is carpal tunnel syndrome.

Carpal tunnel syndrome typically affects people between the ages of 30 and 60, with men more likely to experience the condition than women. It also happens that a person has a very narrow carpal tunnel from birth - in this case, the syndrome will most likely develop over time.

Some people believe that repeating the same movements over and over again causes arm pain, but this is not necessarily true - although some repetitive movements should still be avoided. It is absolutely known that the constant use of vibrating tools increases the risk of acquiring the syndrome - for example, workers who break concrete with a jackhammer are susceptible to it.

However, there are no convincing studies proving that carpal tunnel syndrome is associated with working at a computer (both with a keyboard and a mouse), playing musical instruments or any sport.

The risk of acquiring carpal tunnel syndrome increases:

• Repeated fractures and arthrosis
• Cysts or tumors in the wrist
• Rheumatoid arthritis (an autoimmune disease affecting the joints)
• Hypothyroidism
• Obesity and alcoholism
• Fluid retention in the body (during pregnancy or menopause)

However, most often the syndrome occurs idiopathically, that is, the cause of its appearance is unknown, and treatment comes down to eliminating the symptoms, and not the disease itself.

Symptoms

• Clumsiness when trying to grasp something with your fingers or hand
• Numbness or itching in the thumb or three fingers nearby (index, middle, ring)
• Constant itching in the palm of the hand
• Difficulty when trying to pick up a bag, weakness when trying to grasp something (this is a very common complaint)
• Pain extending from wrist to elbow
• Pain in the hands or wrist
• Problems with finger motor skills
• Weakness of one or both arms
• Atrophy of the muscle at the base of the thumb (this occurs in advanced cases)

How do you know when it's time to go to the doctor?

To Don't confuse the symptoms of carpal tunnel syndrome with the symptoms of arthritis, you need to go to the doctor if:

• your arm constantly hurts, and the pain only increases, even if you don’t strain it at all all day;
• When you move your hand, you get the feeling that something is creaking or crackling inside.

Once you are sure that you are not suffering from carpal tunnel syndrome, you can choose the appropriate treatment depending on the severity of the disease.

Diagnostics

For staging accurate diagnosis The doctor may use the Phalen test or the Tinel test.

• Tinel test: tapping (percussion) on the place where the median nerve passes in the wrist, if the syndrome is present, leads to pain in the palm area
• Phalen test: Maximum flexion of the hand for a minute with the syndrome causes itching, numbness or weakness

The most common tests to diagnose carpal tunnel syndrome are:

• X-ray of wrist. It shows whether there is a narrowing of the canal in the places where the median nerve passes.
• Electromyography. This method examines the electrical activity of skeletal muscles.
• Measurement nerve conduction velocity.

The results of the last two studies will definitely deviate from the norm if you have discovered carpal tunnel syndrome using the Phalen and Tinel tests.

Treatment Options

Try wearing it at night for a few weeks. wristband with hard splint so that the hand does not move. If this doesn't help, try wearing it during the day for at least a month. Try not to place your palms under your head while sleeping and apply cold compresses to your wrist.

Medicines

Used to treat carpal tunnel syndrome non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen. May relieve pain for a while corticosteroid injections.

Surgical intervention

Median nerve release- This is a surgical procedure in which the transverse ligament (it is the one that presses on the nerve) is cut. Surgery usually helps, but not in all cases, and recovery after the procedure may take several months.

Surgery is required in more than half of cases, but sometimes usual treatment relieves symptoms of carpal tunnel syndrome.

How to prevent carpal tunnel syndrome?

To reduce the stress on your wrist, you need to slightly change your workplace and home life.

Maintain the correct posture

• During rest your hands should be relaxed, and the hands should not bend. Try to avoid repetitive movements that involve your wrist.
• The computer screen should be at eye level. The keyboard should be positioned low enough so that the hands do not bend when working on the computer.
• Try don't pick things up with three fingers- this increases the load on the wrist. Use your entire brush. If your work requires you to constantly grab, clamp or unscrew something, constantly change your hands and give them a minute or two to rest.

Monitor your sleeping position

When you fall asleep, your arms should be close to your body, and your wrists should neither bend nor straighten. The hands should not be placed under the body or head - this leads to pressure and, as a result, pain caused by carpal tunnel syndrome.

Use ergonomic things

Don't neglect items with well-designed designs, as they will help reduce the risk of wrist injury. These include computer accessories, such as a mouse pad or a pull-out keyboard tray. Remember to take a break from working on the computer from time to time, especially if your hands hurt.

Exercises for wrists and hands

These exercises will help you improve blood circulation and relieve tension.

• Circular movements of the wrists. Place your hands palms down and rotate them first five times left side, and then five more times to the right.
• Thumb stretch. Straighten your palm, take it with your left hand thumb right hand and pull it out and then back. Hold your finger in this position for 10 seconds. Repeat the exercise five times with thumbs both hands.
• Extend all five fingers. Straighten your palm and stick out your fingers. Stay in this position for 10 minutes. Repeat the exercise 3-5 times.
• Flexion and extension. Take a rubber ball and squeeze it 10 times. Then straighten your palm and repeat the exercise with the other hand.

It is possible that exercise alone will not be enough for you: in some cases it is necessary to change your lifestyle, both in terms of work and in terms of rest. Some professions require you to constantly hold vibrating tools in your hands, and this is very harmful to the wrist.

Home Remedies to Treat Carpal Tunnel Syndrome

Folk remedies are aimed at relieving inflammation and thereby relieving the pain caused by carpal tunnel syndrome.

• St. John's wort infusion: take three leaves of St. John's wort, pour a glass of water and boil for 10 minutes. Drink at least one cup of the infusion daily to relieve pain and itching caused by carpal tunnel syndrome. In addition, this drink has a calming effect, which will help you cope better with pain. And this will help break the vicious circle when pain causes negative emotions , which in turn worsen the pain.
• Linseed oil: Take a spoonful daily for 2-4 weeks. Recent studies have shown that fatty acids contained in linseed oil, help relieve inflammation.
• B vitamins: Add foods rich in B vitamins to your diet. These include potatoes, rice, bananas, green vegetables and chicken breast. If you prefer to get your vitamins from tablets, remember that the daily value for B vitamins is 2 milligrams.
• Ice packs on the wrist or hand: Cold counteracts inflammation and relieves pain. In no case Avoid hot compresses if you have carpal tunnel syndrome., they will only make it worse.

And, of course, all the means that promote normal health will help with carpal tunnel syndrome, not to mention about proper nutrition and regular exercise - essential components of a healthy lifestyle.

If carpal tunnel syndrome is left untreated, it will usually not lead to complications. However, if left untreated, then The median nerve may be permanently damaged.

Be that as it may, do not forget that surgery (which your surgeon will probably insist on) is not always the best solution, and the consequences of the operation may be worse than the disease itself. Before contacting a surgeon, do your best and follow the guidelines in our article. If natural remedies do not help, then do not hesitate to visit a doctor.

Carpal tunnel syndrome is a condition that develops when the median nerve inside the carpal tunnel is pinched or injured. In this case, the movements and sensitivity of the fingers are impaired (the first three and part of the fourth fingers are affected).

Carpal tunnel syndrome is considered occupational disease, since it most often develops in people of certain professions, whose activities are associated with monotonous flexion and extension of the hand. For example, musicians, tailors, secretaries (work with a computer mouse and keyboard).

Carpal tunnel syndrome has two other names: carpal tunnel syndrome And carpal tunnel syndrome. Although the last name is not entirely correct, since there are other tunnel syndromes (for example, compression syndrome of the deep branch of the ulnar nerve).

Statistics

The overall prevalence of carpal tunnel syndrome worldwide is between 1.5 and 3%. Moreover, about 50% of all patients are active users of a personal computer.

According to various sources, carpal tunnel syndrome is 3-10 times more common in women than in men.

The peak onset of the disease occurs between 40 and 60 years of age. However, this does not mean that people younger age are not susceptible to this disease: according to statistics, 10% of all patients are under 30 years of age.

It is believed that people who work long hours on a computer every day are most susceptible to developing carpal tunnel syndrome. According to one study, every sixth person examined has it. Users who are at greatest risk are those whose hand is extended by 20° or more in relation to the forearm while working with the keyboard and computer mouse. Carpal tunnel syndrome is a relatively “young” disease. For the first time, a disease similar to carpal tunnel syndrome was described by the English surgeon Sir James Paget in 1854 in a patient with a fracture of the radius at the level of the wrist.

A little later it turned out that the disease can develop in workers performing monotonous movements.

Well, in our time, when the personal computer has firmly entered the life of a modern person, carpal tunnel syndrome has almost become an epidemic. However, science does not stand still. Therefore, there is great news for active personal computer users: a special platform and a flying computer mouse with a magnetic ring have been developed that can withstand the weight of a human hand. This stylish new product can be used both to treat carpal tunnel syndrome and to prevent its development.

The structure and function of nerves

There are about 85 billion nerve cells in our body. They are located in the brain and spinal cord (central nervous system - CNS), as well as in nodes (clusters of nerve cells) lying outside the CNS (for example, spinal ganglia - near the spine).

The processes extending from the nerve cells gather together and form bundles - nerves.

Together, all the nerves form the peripheral nervous system, whose task is to transmit impulses from the brain and spinal cord organs and tissues. Moreover, each nerve is responsible for its own area or organ.

Structure of a nerve cell (neuron)

Nerve cell(neuron) - structural highly specialized unit nervous system, which has body(somu) and shoots(axon and dendrites).

Body The nerve cell contains a nucleus, and is limited on the outside by a wall, which consists of two layers of fat. Due to this, only fat-soluble substances (for example, oxygen) enter the cell.

Neurons have different shapes(spherical, spindle-shaped, stellate and others), as well as the number of processes. Depending on the function they perform, neurons are sensitive (receive impulses from organs and transmit them to the central nervous system), motor (send commands from the central nervous system to organs and tissues), and intercalary (communicate between sensory and motor neurons).

Nerve cell body incapable of reproduction (division) and restoration when damaged. However, when an axon or dendrite is cut, the cell ensures restoration of the dead portion of the process (growth).


Axon and dendrites

Axon- a long process of a nerve cell that transmits excitation and information from neuron to executive body or tissues (such as muscles).

Most nerve cells have only one axon. However, it can divide into several branches that connect with other cells: muscle, nerve or glandular. This connection between the axon and the target cell is called a synapse. Between the axon and the cell there is a synoptic cleft.

At the end of each axon branch there is a thickening in which there are vesicles with a special substance - a mediator. Before certain point it is in a "sleeping" state.

On the outside, most axons are covered with Schwann cells (perform a supporting and nutritional function), which form the myelin (pulp) sheath. Between the Schwann cells there are nodes of Ranvier, an area where the myelin sheath is interrupted. However, some axons lack Schwann cells - unmyelinated fibers.

The peripheral nervous system is characterized by myelin fibers.

Dendrites- short branched processes of a neuron, with the help of which it receives information from body cells and other nerve cells.

Nerve structure

A nerve is a structure in which there are intertwined bundles of nerve fibers (mainly axons) running parallel to each other.

On the outside, the nerve is covered in three layers:

1. The endoneurium contains capillaries (small vessels) that supply nerve fibers.
2. The perineurium, which “dresses” bundles of nerve fibers, since it contains collagen (a protein that is the basis of connective tissue), which performs a supporting function.
3. The epineurium is the outer layer formed of dense connective tissue that surrounds the nerve.

Nerves transmit impulses from the brain and spinal cord to the cells of organs and tissues of the body.

How is a nerve impulse transmitted?

This difficult process, which is carried out using a sodium-potassium pump. What does this mean? The fact is that the wall of the outer layer of the axon is a complex structure (membrane), thanks to which sodium and potassium ions can flow both into and out of the axon. As a result, an impulse is formed, which is transmitted from the axon to other cells.

How does impulse transfer occur?

Normally, the axon is at rest and does not conduct impulses. Therefore, potassium ions move inside the axon body, and sodium ions move out (much like if a fresh cell is placed in a salty solution).

However, when an impulse arrives at the axon from the dendrite, the situation changes: sodium moves inside the axon, and potassium moves out. As a result, the internal environment of the axon acquires a positive charge for a short period, leading to the cessation of sodium influx into the cell. But at the same time, potassium continues to leave the axon.

Meanwhile, sodium ions inside the cell spread to other parts of the axon, changing the permeability of its membrane, thus facilitating further propagation of the impulse. When it passes through a certain point in the axon, the body of the nerve cell receives a “command” to relax, so it returns to a state of rest.

This impulse transmission is quite slow (for example, a signal sent by the brain reaches the hand after a minute). However, thanks to the myelin sheaths, it speeds up as it “jumps” through the intervals of Ranvier.

However, the impulse must reach an adjacent cell. To do this, having reached the thickening at the end of the neuron, it promotes the release of mediators from the vesicles, which enter the synoptic cleft. Next, the mediators connect to special receptors on the cell of the target organ (muscles, glands, etc.). As a result, an action occurs: movement of the hand, fingers, turning the head, and so on.

Anatomy of the hand, wrist and forearm

The hand is a part of the human hand that has three sections:

All the bones of the hand are connected to each other by joints, ligaments and muscles. Thanks to this, movements in the hand become possible, which are controlled by the nervous system.

Forearm - part of a person's hand that consists of two tubular bones(length prevails over width): radial and ulnar. On the upper side it is limited by the elbow joint, and below by the wrist.

Structure and functions of the median nerve

Features of the passage

The median nerve begins in the shoulder area from branches formed by fibers of the spinal nerves (sixth to eighth cervical and first thoracic). Then it goes to the hand, but does not give any branches at the level of the shoulder and ulnar fossa.

Having reached the forearm area (from the elbow to the hand), the median nerve gives off several branches. Then it passes in the carpal tunnel under the transverse carpal ligament and branches into terminal branches.

Along its course, the median nerve innervates the following muscles:

• Superficial and deep flexor digitorum, which are responsible for flexing fingers II-V
• The muscle that helps flex and rotate the forearm is the pronator teres.
• Flexor carpi muscle - flexes and abducts the hand
• The flexor muscle nail phalanx first finger
• The palmaris longus muscle, which flexes the hand and tenses the palmar aponeurosis (a wide tendon plate that covers the muscles of the hand from the palmar surface)
• The quadratus muscle, which is responsible for rotating the hand and forearm
• Abductor pollicis muscle
• The muscle that opposes the thumb to all the others
• Muscle that flexes the thumb
• Muscles that bend II-III fingers.

Functions of the median nerve

Based on the areas of innervation, the median nerve is involved in flexion and abduction of the hand to the inside, flexion of the fingers, bringing the elevation of the first finger to the other fingers of the hand, rotation of the hand and forearm.

Also, the median nerve innervates the skin on the palmar surface of the hand of the first, index and middle, as well as parts ring finger, and on back surface brush skin of the terminal phalanges of the index and middle fingers.

Thus, the median nerve provides both movement and sensation to the hand.

Causes of median nerve damage

The lumen of the carpal tunnel is quite narrow. Therefore, any factor that leads to its narrowing or provokes the growth of tissue inside it can cause the development of carpal tunnel syndrome, since this compresses the median nerve between the bones and tendons of the wrist.

Working at a computer for a long time (using a computer mouse and keyboard)

Most often leads to the development of carpal tunnel syndrome, since this type of activity causes minor chronic injury to the soft tissues of the hand, as well as the tendons running in the carpal tunnel. The reason is repeated, similar, fast and frequent movements of the hand and arm. As a result, aseptic (non-bacterial) inflammation of the tendons passing in the carpal tunnel occurs, which leads to their swelling and pinching by the retinaculum.

However, studies have shown that not all frequent personal computer users develop carpal tunnel syndrome. Certain conditions are necessary for it to occur. For example, people most often at risk are those with III-IV degree of obesity (the lumen of the carpal tunnel narrows due to fat), female gender (anatomically narrower carpal tunnel) and some other factors.

Arthritis: rheumatoid, psoriatic or gouty arthritis, as well as other rheumatic diseases affecting the joints

At the onset of the disease, an inflammatory reaction occurs in the joints of the wrist area. Besides, systemic diseases(affect the body as a whole) lead to the development of inflammation and swelling of soft tissues, including muscles and tendons passing through the carpal tunnel, therefore its lumen narrows.

Then, over time, as the course of the underlying disease worsens, articular cartilage aging occurs. Therefore, they lose their elasticity and cracks appear on them. As a result, the cartilage gradually begins to wear away, and in some places so much so that the bone is exposed. Such changes lead to cartilage death and fusion articular surfaces. Therefore, deformations occur, as a result of which the normal anatomical structure of the hand and carpal tunnel is disrupted.

Acute wrist injuries

They cause the development of carpal tunnel syndrome in approximately 10% of all cases of the disease. Quickly suppress the production of inflammatory mediators in tissues (histamine, prostaglandins). Therefore, pain and swelling are reduced, and tissue sensitivity is improved.

However, systemic corticosteroids have big amount side effects (for example, sleep disturbance, formation of ulcers in the stomach and intestines). Therefore, they are used with caution, especially for certain diseases (for example, diabetes). In addition, they suppress the activity immune system, therefore, in the presence of infections they are not prescribed.
There is one more unpleasant moment: after corticosteroid withdrawal, “rebound” syndrome may develop: all symptoms quickly return.

Local treatment

Considered most effective for relieving acute symptoms.

Introduction of medicinal mixtures

A medicinal mixture of an anesthetic (Lidocaine or Novocaine) with a corticosteroid hormone (Diprospan or hydrocortisone) is injected into the carpal tunnel using a special long needle. As a rule, after administering medications into the carpal tunnel cavity, pain and other symptoms of the disease disappear after some time. However, in some cases, the pain may increase, but after 24-48 hours it gradually decreases.

With this method of treatment, the patient’s condition improves after the first injection. If the symptoms do not disappear completely, then two more procedures are performed with a two-week interval between them.

If the disease relapses (symptoms reappear), the course of treatment is repeated.

Local compresses with a complex composition

One of the composition options:

• Dimexide - 50 ml
• Lidocaine solution 10% - 2 ml, or Novocaine 2% - 30 ml
• Hydrocortisone solution - 1 ampoule
• Water - 30 ml

The compress is applied for 40-60 minutes.

The prepared composition can be stored in a cool place and used for several days.

Carpal tunnel syndrome: surgery

Surgery is recommended if symptoms persist for 6 months.

The purpose of the intervention is to reduce pressure on the median nerve by expanding the lumen of the carpal tunnel.

There are two types of surgery that are performed under local anesthesia:

After the operation, a plaster cast is applied to the wrist area for several days. As rehabilitation treatment physiotherapy is used and physiotherapy(finger movements should be carried out with a fixed wrist).

3 months after surgery, hand function is restored by 70-80%, and after 6 months - completely.

After recovery, the patient can return to his ordinary family activities. However, if you do not change working conditions (proper arrangement of the workplace, use of cuttings), there is a high risk of relapse (return of symptoms of the disease)

Non-drug treatment

Many doctors use acupuncture to treat carpal tunnel syndrome. manual therapy and other techniques.

For hypothyroidism Hormone replacement therapy is prescribed: L-thyroxine, Eutirox.

During menopause physiological or artificial (removal of ovaries) for replacement therapy hormonal medications containing estrogen (female sex hormone) are prescribed. However, such treatment is only possible if the woman had her last menstruation no later than 10 years ago and she is under 60 years of age.

If a menstruating woman has taking hormonal contraception, carpal tunnel syndrome has developed, then they are canceled or changed to another drug.

Treatment of diabetes aimed at preventing jumps in sugar levels during the day. Since it is in this case that the large quantities substances that damage neurons. However, treatment has its own characteristics depending on the type of disease.

For type I diabetes, insulin (short-, long- or medium-acting) is prescribed. The dosage and regimen of use is individual, depending on the severity of the disease and blood sugar levels.

For type II diabetes, glucose-lowering drugs (Glucophage, Metformin) are prescribed, which increase the sensitivity of cell walls to insulin, improving the intake of glucose. In addition, they reduce the formation of glucose in the liver, as well as its absorption in the intestine.

While maintaining partial function of the pancreas, drugs are used that stimulate the production of insulin by its cells. These are sulfonylurea derivatives: Chlorpropamide, Gliquidone and others.

Regardless of the type of diabetes, thioctic acid preparations (Tiogamma, Berlition) are prescribed to improve tissue nutrition. They improve the absorption of glucose by tissues, bind free radicals (unstable molecules that damage other normal cells of the body), especially cells of the nervous system.

For chronic renal failure treatment is aimed at improving function and blood circulation in the kidneys, eliminating excess liquid from the body and end products of protein metabolism.

For this purpose, drugs that thin the blood and improve blood circulation in small vessels are used (for example, Warfarin, Angioflux).

Sometimes diuretics are prescribed (depending on the degree of preservation of kidney function).

Sorbents (Polysorb, Enterosgel and others) are used to remove the end products of protein metabolism.

For high blood pressure, medications are used to regulate it: ACE inhibitors(Diroton, Captopril), calcium antagonists (Verapamil) and others.

In case of severe renal failure (stages III-IV), the patient is connected to an artificial kidney apparatus.

Physiotherapeutic procedures

They have proven themselves well both during treatment with medications and during the rehabilitation period after surgery.

However, despite their effectiveness, they are not suitable for everyone.

General contraindications to physiotherapeutic procedures

• Tumor processes
• Pregnancy
• Severe III degree heart failure
• Any infectious viral diseases in acute period(presence of elevated body temperature)
• Severe diabetes mellitus ( high numbers Sahara)
• Increased arterial pressure- temporary contraindication. After its normalization, the procedure can be carried out.
• Presence of a pacemaker
• Epilepsy with frequent seizures, hysteria and psychosis
• Reduced blood clotting and bleeding tendency
• Severe heart rhythm disturbance: severe atrial fibrillation (contraction of the ventricles and atria is asynchronous) and severe extrasystole (in this disease the heartbeat)
• Presence of pustular inflammation on the skin (site of device exposure)

Physiotherapeutic procedures are prescribed both for the treatment of carpal tunnel syndrome and the diseases that led to its development.

Ultraphonophoresis

Performed together with medications.

During the procedure, the body is affected by ultrasonic vibrations, which facilitate the penetration of drugs into the cell.

In addition, the therapeutic effect of ultrasound itself: it dilates blood vessels and accelerates blood flow in the capillaries. Thanks to this, pain decreases or disappears, swelling decreases and hematomas resolve.

Dimexide, painkillers, hormones and other drugs are used as medicines. An exception is some medications that ultrasound destroys: novocaine, B vitamins, ascorbic acid and other substances.

The goals are to reduce pain and inflammation, accelerate tissue restoration.

Indications

• Diseases of the musculoskeletal system: osteochondrosis, arthrosis, arthritis, (vascular disease)
• Active pulmonary tuberculosis
• Individual intolerance to drugs for ultraphonophoresis

Method of application

First, the medical worker wipes disinfectant solution the area of ​​skin that is subject to the procedure. Next, the medicine is applied to the skin, then a device that delivers ultrasonic waves is applied to the site of treatment.

The duration of one procedure is from 10 to 30 minutes. Course - 8-12 sessions. After a few months, if necessary, the course of treatment is repeated.

Shock wave therapy

The method is based on the action of acoustic shock waves (generated by a special sensor), the frequency of which is lower than perceived human ear- infrasound. These waves have a high amplitude of energy and a short duration, due to which they propagate in soft tissues without damaging them. At the same time, they restore metabolism and promote cell renewal.

As a result, blood circulation in the affected area improves, pain decreases, and sensitivity is restored. Moreover, after several procedures they begin to disintegrate. bone spurs, and new vessels grow at the site of the lesion.

The method is so effective that if treatment is started in a timely manner, it is equal to the result obtained after surgery.

Goals

Treatment of acute and chronic pain caused by injury, diseases of the musculoskeletal system (osteochondrosis, arthritis and others) and the nervous system.

Indications

• Arthrosis, arthritis, osteochondrosis, hernia and protrusion of intervertebral discs, heel spur
• Gallbladder and kidney stones
• Slow healing of fractures
• Soft tissue injuries: muscles, ligaments, tendons
• Scar tightening of muscles, tendons and ligaments, so free movements (flexion, extension) in the limb are limited
• Pain from bruises, fractures, sprains
• Burns and trophic ulcers
• Chronic muscle pain resulting from prolonged and frequent overwork

Contraindications

(in addition to the general ones)

Age up to 18 years, since the waves act on the growth zones of bones. Whereas when they are damaged, irreversible changes develop that have a bad effect on the development of the child’s skeleton.

Methodology

The medical worker helps the patient get more comfortable on the couch, then wipes the area of ​​skin, disinfecting and degreasing it. Then it configures the device depending on the area of ​​application and the disease (there are several programs). Next, a special gel is applied to the skin, after which a sensor is applied to the site of treatment, which sends therapeutic impulses.

The course of treatment is 5-7 procedures, each of which lasts 20-30 minutes. The procedures are carried out at intervals of 3-7 days. After treatment, about 90% of patients have a significant improvement in their condition. If necessary, the course of treatment is repeated after several months.

On a note

Do not apply shock waves to the area of ​​the head, intestines, large blood vessels and lungs.

Prevention of carpal tunnel syndrome

According to statistics, the number of patients with carpal tunnel syndrome has increased in recent years, as the personal computer has become firmly established in the life of a modern person. However, the formation of the disease can be prevented.

So, what to do based on the mechanism of development of the disease?

Arrange your workplace
Select the height of the computer desk so that the armrests of the chair are level with its surface. In this position, while working (typing or moving a computer mouse), the forearms rest quietly on the table or armrests, and are not suspended. Therefore, the hands are relaxed while working, and the hand at the wrist does not bend. In this case, there is no additional load on the canal and the median nerve is not pinched.

In addition, while working, try to ensure that the lower back is positioned at an angle of 90° in relation to the hips, and the angle between the shoulder and forearm is also 90°.

Try not to strain or squeeze. Be careful not to pull your head between your shoulders.

Choose a comfortable keyboard and computer mouse
If the position of the hands is correct during work, then the hands lie calmly above the working surface, so movements in them are free. However, if the keyboard is located high, you have to hold your hands above it in a suspended position. This position increases the load on the carpal tunnel. Therefore, it is better to purchase a special hand mat or an inclined keyboard.

Choose a computer mouse so that it fits in your palm while you work. This way the hand gets tired less and is relaxed. For people who have already developed carpal tunnel syndrome, special computer mice have been developed that are shaped like a joystick. When working with them, the carpal tunnel is practically not loaded.

In addition, there are special computer mouse pads that have a cushion (it is better to choose one with a gel filler) at wrist level. In this position, during work, the carpal tunnel is in a straightened state and is minimally loaded.

Position of the brushes when working

Adjust the angle and height of your monitor

In such a way that the text is at eye level while working. Because if the monitor is located low, then you have to constantly tilt your head down, if it is high, then raise it up. With such movements, blood circulation in the cervical spine spine and arms.

Carpal tunnel syndrome occurs when the median nerve is compressed. The pathological process is accompanied negative symptoms. Carpal (wrist syndrome) develops more often in women, but men also suffer from this pathology.

Damage to the median nerve is often associated with characteristics of professional activity, and often develops against the background of bad habits. How to protect your hands from nerve compression? How to recognize carpal tunnel syndrome in time? Let's figure it out.

general information

The carpal tunnel in the hand area is formed by the transverse ligament on the upper side, the carpal bones below and on the sides. Damage to the median nerve occurs when the anatomical canal is compressed. With absence pathological changes nerves and tendons pass inside the tunnel, excess pressure provokes a narrowing of the cavity, damage to the sensitive branches responsible for the innervation of the fingers.

Why do women suffer from carpal tunnel syndrome more often than men? The carpal tunnel in the fair sex already, throughout life female body experiences many phenomena related to hormonal changes: menopause, pregnancy, taking hormonal contraceptives.

Reasons for the development of the disease

Doctors do not give an exact answer to the question about the origin of pathological processes in the carpal tunnel area. There are many factors that increase the risk of median nerve compression in the hand. With age, the risk of pathological changes increases. Often negative factors somewhat, the disease is more acute.

Compression of the nerve in the wrist area occurs in the following cases:

• microtrauma due to constant impact on areas of the hand (construction, renovation work, the need for long-term use of a computer);
• swelling of tissues, stretching due to injury to the hand;
• negative processes accompanied by deformation of the tendons and carpal tunnel against the background hormonal imbalances and some diseases (hypothyroidism, the appearance of osteophytes, menopause, pregnancy);
• high degree of obesity;
• poor blood supply to tissues due to smoking;
• tumors in the wrist or carpal tunnel (lipoma, hemangioma, neurofibroma).

Many doctors consider carpal tunnel syndrome occupational disease programmers, system administrators, webmasters. Previously pathology diagnosed at age 40 and later, now problems with the hands, compression of the median nerve often occurs in young people under 35 years of age.

First signs and symptoms

Negative signs initially appear only after prolonged exercise. As the pathological process progresses, with significant narrowing of the canal, the symptoms become more acute.

It is worth paying attention to the following signs:

• numbness of fingers. Negative symptoms appear only at night, fingers from first to fourth are affected;
• there is pain in the hand area, tingling;
• Often patients feel as if they have “goosebumps” inside;
• hands become weak.

With further compression of the nerves and tendons, new signs are added:

• muscles atrophy;
• It is more difficult to perform habitual hand movements than before;
• it is impossible to make small, precise movements with your fingers;
• if the case is severe, discomfort spreads to the forearm, elbow area, and shoulder.

Diagnostics

The following tests can help confirm or refute the diagnosis of carpal tunnel syndrome:

• Durkana.
• Falena.
• Tinelya.

Also carried out:

• electrodiagnostics;
• opposition test;
• shaking your fingers to control sensitivity.

It is important to differentiate carpal tunnel syndrome from pathologies that have similar symptoms:

• cervical radiculopathy;

Effective treatments

If compression of the anatomical canal in which nerves and tendons pass is confirmed, the doctor recommends complex therapy. The pathology is treated by a traumatologist-orthopedist and a neurologist.

Not only drug therapy is required, but also physiotherapy, therapeutic exercises, and limiting the load on the problem area. You cannot exercise during treatment professional activity, which involves monotonous movements of the arm and hand.

Medications

Effective medicines reduce pain, remove swelling. The action of the compositions allows the compressed canal to return to its usual size and eliminates the cause for the development of negative symptoms.

• drugs that relieve inflammation - . Potent tablets, ointments, and gels prevent the spread of the inflammatory process to new areas, reduce swelling, and relieve pain in the problem area. Effective compositions: Diclofenac, Nise, Voltaren, Indomethacin, Acetylsalicylic acid, Ibuprofen, Ketoprofen, Naprofen. The selection of drugs is carried out by the attending physician: medications have contraindications for use; many formulations in tablet form irritate the mucous membranes of the stomach and intestines and have a negative effect on the liver;
• hormonal drugs to eliminate pain, break the chain of the inflammatory process. A short course of active treatment using Hydrocortisone and Prednisolone is recommended. Intra-articular injections – effective method eliminate inflammation, reduce pain. Hormonal drugs have more side effects than NSAIDs; long-term use often leads to irreversible damage in various parts of the body.

Other treatment methods supplement the use of medications:

• electrophoresis with hydrocortisone and analgesics;
• wearing special splints and orthoses to fix the affected hand in a physiological position;
• in the early stages of pathology, mild pain syndrome is helped by applying cold, reducing the load on the hands and fingers.

Folk remedies and recipes

Proven recipes:

• cabbage leaf compress to relieve swelling and reduce inflammation. The effectiveness of the procedure is increased by applying thin honey to the surface of a cut cabbage leaf. The combination of a beekeeping product and cabbage juice has a positive effect not only for carpal tunnel syndrome, but also for arthritis, rheumatism, gout, and periarthritis of the shoulder joint;
• contrast baths with chamomile infusion, sea salt, sage infusion. Each product has a positive effect on the condition of the hands, reducing swelling and inflammation. To prepare a decoction of medicinal herbs, pour a tablespoon of the raw material into a liter of boiling water, let it brew for an hour, and strain. Hand bath with sea salt - 2 liters of warm water plus two tablespoons useful product. The duration of the procedure is no more than a third of an hour, the water temperature is no higher than +36 degrees;
• compress with horseradish leaves. Another simple way to reduce pain in a problem hand. Before use, dip the washed leaves in boiling water for a minute, shake off the water, cool, wrap the affected area, and leave for 45 minutes. After the procedure, apply nourishing cream. If the skin of your hands is tender and flaky, it is advisable to lubricate your hands with vegetable oil before the treatment session;
• diuretic tea against tissue swelling. Stopping excess pressure on the anatomical tunnel is the main goal of therapy. There are many recipes for teas and herbal infusions that accelerate the removal of excess fluid from the body. They do the job well medicinal herbs, fruits and berries: dill, lingonberries, parsley, cornflower, bearberry. Useful action Corn silk, wild strawberry, horsetail, and knotweed provide benefits. Diuretic berries and herbs are used with caution. There are restrictions: in particular, active removal of fluid using traditional medicine and drugs is prohibited during pregnancy.

Important! Usage traditional methods complements drug therapy and physiotherapy, but does not replace them. In difficult cases it only helps surgery. The operation removes compression of the problem area. The surgeon partially or completely cuts the transverse ligament, and the lumen of the anatomical canal is restored.

Possible complications

Not all patients turn to a neurologist and orthopedist-traumatologist on time, especially when mild pain in a periodic brush. The longer the start of treatment is delayed, the higher the risk severe defeat median nerve.

In advanced cases, the nerve fibers atrophy, and the mobility of the fingers is impaired due to the lack of innervation. Untimely therapy often leads to loss of sensitive and motor function fingers.

Find out more about characteristic features and methods of treating the knee joint.

Effective options for treating rheumatoid arthritis at home using folk remedies are described on the page.

Go to the address and read about the benefits and use of the decoction bay leaf for joints.

Prevention measures

Carpal tunnel syndrome interferes with normal activities and manifests itself as discomfort in the hand. Every person should know preventive measures to reduce the risk of pathological changes in the hand area.

How to proceed:

• stop smoking: lack of nutrition worsens the condition of blood vessels and nerve fibers;
• take breaks from working at the computer, remember to take a five-minute rest every hour, and do not forget about exercises for your hands and fingers;
• relax your arms and hands more often when painting and plastering. Builders and repairmen should massage their hands and, after a shift, apply ointments and gels with a cooling, decongestant effect;
• properly equip the workplace to minimize stress on the hands. At long work At the computer, armrests are required to support the elbows;
• be sure to use a mouse pad, place the brush further from the edge, maintain the bend angle in the elbow area at 90 degrees;
• exercise every day, do exercises. Good condition musculoskeletal system, the elasticity of the ligaments reduces the risk of developing carpal tunnel syndrome;
• control body weight. The fewer extra pounds, the lower the load on joints and cartilage tissue;

Video. Elena Malysheva about carpal tunnel syndrome:

Very often, when performing long, monotonous work, for example, in construction or sitting at a computer, a person experiences numbness in his hands, tingling in his fingers, and weakness in his wrists. All these are symptoms of a condition such as carpal tunnel or carpal syndrome. Pathology poses a threat to a person’s normal life and work, and therefore requires professional therapy. Let's try to figure out what the problem is.

Trauma concept

Carpal tunnel syndrome is an unpleasant condition of the hands, most often the right one, associated with long, monotonous work. Pathogenesis consists of infringement of nerve pathways- the median nerve, innervating the hand and fingers, in the carpal tunnel. The latter is anatomically a passage on the inside of the wrist that connects the hand and forearm and which serves as a “tunnel” for the nerve and surrounding tendons. In total, the canal contains tendons of nine muscles that flex the fingers. In addition, the small bones of the wrist are in close proximity.

Outward from the carpal tunnel runs the ulnar canal, in which the ulnar nerve and the ulnar artery are located.
Due to prolonged pressure or strong mechanical impact, the median nerve in the canal can be compressed, which leads to its neuropathy.

Directly, this condition can cause thickening of the flexor tendons located nearby; swelling and thickening of the neural pathway.

According to statistics, women most often suffer from carpal syndrome, with peak susceptibility to the pathology occurring between 45 and 65 years of age. In total, about 3% of all people turn to specialists for this condition, which makes it one of the most common diseases in everyday life.

Not only the median nerve, but also other nerve pathways of the arm can become pinched.

Carpal tunnel syndrome is classified into the following types depending on what is affected:

• Carpal tunnel syndrome (carpal syndrome) is a disease of the median nerve
• Cubital tunnel syndrome (cubital syndrome) - the ulnar nerve is pinched
• Radial nerve compression syndrome

Causes of Carpal Tunnel Syndrome

According to recent studies, the anatomical narrowness of the canals, and, consequently, the predisposition to their pinching, is genetically determined.

The following conditions directly lead to carpal tunnel syndrome:

• traumatic injuries of the tendons and muscles of the forearm
• congenital developmental pathologies in the musculoskeletal system of the hand - excess tendon fibers; bone spurs blocking the canal
• pathologies of the nerve pathway itself - thickenings of both the nerve itself and neoplasms located beyond it
• disruption of blood microcirculation
• other accompanying illnesses(eg, rheumatoid arthritis, rheumatism, gout)

The above reasons alone for the development of pathology are often not enough.

The syndrome also develops against the concomitant background of the following conditions:

1. Poor nutrition.
2. Obesity.
3. Smoking, drinking alcohol, addiction to drugs.
4. Diseases of the metabolism and endocrine system (diabetes mellitus, gigantism, disorders of the thyroid gland).
5. Pregnancy.
6. Professional factor - people who perform repeated stereotypical movements during work (for example, stenographers) are susceptible to this disease almost 10 times more often.

The syndrome can even develop in the average person after working for many hours at a computer, if you do not basic principles occupational health and neglecting breaks.

How does carpal tunnel syndrome manifest?

The clinical picture includes numerous manifestations:

• Pain in the wrist area. It occurs first with various movements and loads, then is felt at rest. Patients often suffer from attacks at night. Discomfort arises both due to a possible inflammatory process in the canal area, and due to direct pinching of the nerve pathway and its damage (neuropathy). In particularly severe cases, pain may be a result of muscle spasm.
• Hyperpathy is observed - a change in pain sensitivity, as a result of which even minor stimuli cause a strong response that spreads throughout the hand (the localization of pain becomes unclear, vague). Aftereffects are observed.
• Allodynia - a person feels the effect of stimuli that actually have no effect. With carpal tunnel syndrome, patients often feel the passage electric current by hand.

• General weakness when performing movements.
• Tingling in fingertips.
• Feeling of numbness in hands.
• Presence of edema.
• Pallor of the skin.
• For special severe forms hand muscle atrophy develops, characterized by the flexion of some and extension of the other phalanges with the fingers apart (the so-called “clawed paw” symptom).

Pathology

Diagnosis is based on the totality clinical symptoms, for this purpose, first of all, anamnesis is collected.
In this case, special functional tests are used:

1. 1. Phalen's test. It is considered positive if when the patient raises his arm above his head painful sensations weaken or disappear.
   2. Tinel's test. Tapping a neurologist's hammer on the wrist causes sharp painful sensations in the hand.
   3. Durkan's test. The doctor squeezing the wrist causes discomfort to the patient.
   4. Wartenberg's test. When you put your hand in your pocket, your little finger bends to the side.
   5. Frohman's test. the patient is asked to hold a piece of paper with his thumb and forefinger. The test is considered positive if there is excessive flexion of the thumb at the joint.

1. The presence of carpal tunnel syndrome is confirmed if, when shaking the hand, the pain disappears or its intensity decreases.
2. An important and simple sign is if the patient is unable to connect the thumb with the little finger.

From laboratory methods using electroneuromyography, during which the speed of nerve impulse transmission along the fiber is measured, also prescribed ultrasonography and magnetic resonance imaging to detect anatomical abnormalities in the canals or the presence of tumors.

Treatment methods

Usually people turn to a specialist not from the very beginning of the disease, but when it has already reached its peak - there is unbearable pain, especially at night. The choice of treatment tactics is based on determining the cause of compression and its severity.

First of all physical impact on the injured wrist should be stopped and it should be immobilized. Bandages and sports bandages are used to immobilize the limb. They are easy to apply, they do not make it difficult for a person to wear, maintaining his physical activity.

In particularly severe forms, the application of a splint is simply necessary. This retainer is a wide plaster bandage. Having previously moistened it in hot water, apply in several layers to the hand, generously lubricated with a greasy cream (for example, Vaseline) to facilitate subsequent removal. The splint immediately hardens when applied to the hand, then it is fixed with rounds of bandage. The procedure should be performed so that the fingers on the hand remain free and are not constrained in movement.

Another undoubted advantage is the ease of removal.. Unlike plaster, which requires complex manipulations to cut it, the splint is simply removed after unwinding the bandage.
In milder cases, it is possible to use kinesiological or hard sports tapes or ready-made fixatives.

To eliminate symptoms, medications are prescribed. Non-steroidal anti-inflammatory drugs are widely used for carpal tunnel syndrome ( Diclofenac, Ibuprofen, Ketoprofen), they have analgesic and anti-inflammatory effects. Although these products are available in pharmacies without a prescription, it is important to remember that they cannot be used for a long time; you should always consult a specialist.

It is possible to use muscle relaxants, anticonvulsants, drugs that facilitate the outflow of fluid and relieve swelling, as well as medications that improve blood microcirculation in the area of ​​damage. All of them do not begin to act immediately and relieve pain after some time.

At severe pain Your doctor may prescribe injections of corticosteroid hormones (hydrocortisone, usually given with novocaine). Such a blockade is extremely effective, however, due to the complex selection of the dosage, it is prescribed only when it does not work non-steroidal drugs and other analgesics.

Physiotherapeutic procedures can be very effective: electrophoresis, ultrasound treatment, the use of magnetic therapy and the action of weak electric currents. We should not forget about massage: performed by a qualified specialist, it helps improve blood circulation and relieve muscle spasms.

Another way is to influence special points, which are called trigger points. These are muscle knots that can appear on the wrist and contribute to the development of carpal tunnel symptoms. Daily massage of these sensitive points often helps relieve muscle spasm and minimize the manifestations of carpal tunnel syndrome.

The most in a radical way The only treatment left is surgery. It is prescribed when all methods conservative therapy did not give the desired result. During surgery, an incision is made in the carpal tunnel ligament to relieve pressure on the median nerve.

The intervention can be performed either using an endoscope, when large incisions are not made on the skin, but a camera is inserted through a small hole, or open method. During the latter, the wrist and part of the hand are opened, this significantly complicates and lengthens the recovery time, in addition, a scar remains on the hand.

Despite its simplicity, surgery does not always completely remove carpal tunnel syndrome. therefore, relapses of pain are possible.

For get well soon after the operation, vitamin complexes are prescribed, it is recommended to change the diet: fatty, salty, fried, spicy foods should be excluded; eat more fresh vegetables and fruits, steamed meat, fish and poultry.

Carpal tunnel syndrome can be easily avoided by following a few simple rules:

1. When working at the keyboard, you should take regular breaks. Hands should be kept straight, elbows bent at right angles.
2. The workplace at the computer should be comfortable so that your hands do not hang in the air.
3. Keep your hands warm while typing. There is a proven connection between low indoor atmosphere and decreased mobility of the hands and wrists. However, if an attack of pain has already occurred, the use of cold compresses will be extremely useful. It is enough to apply cold for 10 minutes and the discomfort will decrease.
4. Exercises for the hands are necessary: ​​the hands can be rotated, bent, pulled, and massaged independently. The fingers are bent together and alternately, clasped together, spread as far as possible. It is useful to use improvised means: a variety of hand expanders are simply irreplaceable for people who perform a lot of monotonous movements with their hands.

Carpal tunnel syndrome is an extremely unpleasant condition.
Without qualified assistance it can lead to serious disorders of the musculoskeletal system of the hand, up to total loss its functional activity! That is why it is important to immediately consult a doctor at the first symptoms of the condition.

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